Commencing in Oregon in Holt County, the highway travels west, from its southern terminus, out of town 2.5 miles (4.0 km) to Forest City.

It runs concurrently with US 159 west for around five miles (8.0 km) passing Fortescue to the south, then turns north just southeast of Big Lake.

The highway passes by the national historic place, St. John’s Evangelical Lutheran Church, in Corning Missouri.

Leaving Corning, the highway travels northwesterly, exiting Holt County, Missouri after 1.5 miles (2.4 km).

The highway crosses Interstate 29 (I-29) at exit 107 and continues north-northeast three miles (4.8 km) up the Loess Bluffs towards Rock Port.