NY 122 serves as a northerly bypass of the village of Malone, situated 6 miles (10 km) to the south.

The route initially heads eastward from NY 37 as a rural, two-lane road before ducking to the southeast.

NY 122 soon enters the hamlet of the same name, where the undeveloped surroundings give way to a stretch of residences on both sides of the highway.

The highway continues east from NY 30, serving residences in the eastern part of the hamlet before curving to the southeast and entering another rural area.

NY 122 ends 1.5 miles (2.4 km) later at an intersection with US 11 just west of the hamlet of Burke Center.