It connects the city of Mount Airy with the northern end of Surry County and Virginia State Route 103 (SR 103).

[2] The western terminus is at NC 89 and U.S. Route 52 Business in downtown Mount Airy.

After traveling for about one-quarter mile (0.40 km) along East Pine Street, the highway intersects NC 104 at the latter's southern terminus.

The highway travels through the community (and census-designated place) of Flat Rock before it heads into a more rural and mountainous area.

It curves around Slate Mountain and passes through the community of the same name before reaching the Virginia state line.