It connects northeast Surry County with downtown Mount Airy following Riverside Drive.

NC 104 begins at NC 103 in downtown Mount Airy (also known as Pine Street) and immediately heads north along Riverside Drive.

The road passes Riverside Park very close to the southern terminus of the route.

NC 104 exits Mount Airy and crosses the Ararat River (after closely paralleling it for the rest of its route) before ending at the Virginia state line.

In 1930 the road was extended along US 19E then was routed to Loafers Glory.