Nebraska Highway 91 begins at an intersection with NE 2 just north of Dunning.

It heads in a northeasterly direction through the Sand Hills, where it has an intersection with NE 7 south of Brewster.

The highway continues to the east and southeast into farmland, heading into Taylor.

West of Ericson, the highway intersects NE 70, where it then runs concurrently with that route for about 20 miles (32 km).

After passing through Scribner and bypassing Hooper, NE 91/US 275 meet with US 77 and run concurrently southward along it as well.