The southern terminus is in Farmington at New Hampshire Route 11.

The Maine Department of Transportation has installed Maine-style route shields along this section of the road, but the highway retains its New Hampshire designation.

NH 153 is unrelated to Maine State Route 153, which is located over 150 miles (240 km) to the northeast.

The highway skirts the western corner of Milton and continues into Middleton.

NH 153 passes the Province Lake Country Club and proceeds due north along the state border, before turning fully back into New Hampshire in the town of Effingham.