The northern end of the highway is located at a junction with NY 104 in the town of Greece.

The route continues onward, leaving Scottsville and entering an open, rural area of the town of Wheatland.

NY 386 remains on a northwesterly track to the Chili town line, where it curves to the north as it approaches and crosses over the New York State Thruway (I-90).

[4] The highway continues generally northward through Chili, traversing open fields and crossing over Black Creek ahead of an intersection with NY 252.

The amount of development along the overlap remains low until the highway crosses the CSX Transportation-owned West Shore Subdivision, at which point the fields that had surrounded the route are replaced with homes and businesses.

[4] At this point, ownership and maintenance of NY 386 shifts from NYSDOT to Monroe County.

North of the exit, Chili Center–Coldwater Road comes to an end at West Side Drive, forcing NY 386 to turn east onto West Side Drive for 0.5 miles (0.8 km) before returning north and entering the town of Gates on Coldwater Road.

The route continues onward, passing through mostly residential areas as it proceeds into the town of Greece.

The route ends 1.5 miles (2.4 km) later at a junction with NY 104 near Elm Ridge Plaza.

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.