MS 23 ends at the Mississippi–Alabama state line, just west of Red Bay, continuing as SR 19.

The routing that became part of MS 23 was first constructed as a graded road in 1925, from north of Amory to the state line.

It leaves the city limits at Seminole Road and crosses Mill Creek shortly after.

[9] Past Jug Shop Road, MS 23 crosses the Itawamba County line.

[3] Upon entering the county, the route crosses Bluff Creek and travels northeastward.

[4] The road travels north past Cadamy, turning into a divided highway.

[10] At Cotton Gin Road, MS 23 turns north, crosses Mountain Creek and intersects Mt.

[9] MS 23 shifts slightly north past Pineville Road, and it ends at the Mississippi–Alabama state line.

[13][14] The next year, six miles (9.7 km) of the route was paved from West Point southwards.

[38][39] A part of the Appalachian Development Highway System, Corridor V, was constructed to MS 23 by 2014.