Over the course of its routing, NY 153 passes through the towns of Pittsford, East Rochester (also village), Perinton, and Penfield.

The route travels east for a short distance as Washington Road before curving to the northeast, ascending slightly in altitude as it progresses onward.

North of the Golf Avenue junction, NY 153 leaves the village as it travels up another hill before leveling off ahead of Interstate 490,[4] which it crosses by way of an overpass rebuilt in 1994.

[4] A short distance north of Commercial Street, NY 153 passes under the Rochester Subdivision, a double-tracked railroad line owned by CSX Transportation.

On the opposite side of the underpass, NY 153 becomes North Washington Street and intersects Despatch Drive, a local arterial serving a line of warehouses along the railroad tracks.

NY 153 continues on, widening from two to four lanes as it passes through a commercial and industrial neighborhood of East Rochester.

Two blocks north of Despatch Drive, the route meets Linden Avenue, an east–west roadway linking NY 441 in Penfield to Whitney Road in Perinton.

[4] Just inside the town line, the route descends into the Panorama Valley, dropping a total of 100 feet (30 m) over 0.75 miles (1.21 km).

[12] The bridge carrying NY 253 over Irondequoit Creek in Penfield was closed to vehicular traffic in the 1960s;[13] as a result, NY 253 was rerouted north of the junction of North Washington Street and Linden Avenue to follow Linden Avenue eastward across Irondequoit Creek to Whitney Road in Perinton.

Under the terms of the act, it took effect 90 days after it was signed into law; thus, the maintenance swap officially took place on November 26, 2007.

[18] The portion of NY 153 south of West Commercial Street in East Rochester had not been substantially reconstructed since 1915.

Construction paused in November 2007 for the winter months, at which time the highway was reopened to two-way traffic.