Pinetops-Macclesfield Road runs through a mixed area of forests and farms and crosses Bynum Mill Creek.

Leaving the town, the highway turns northwest, partially paralleling NC 43 to the west.

NC 122 remains semi-rural, with several houses and small businesses along the road, but the landscape is still dominated by farms and scattered forest.

[1][2] Crossing over the Tar River, NC 122 exits off of US 64 along with US 258, and heads northeast along a two lane road toward Princeville.

The highway meets up with NC 33 (South Main Street) in the center of town.

As Mutual Boulevard approaches an intersection with Shiloh Farm Road (SR 1523), it enters a residential zone.

Leaving the residential area, the boulevard intersects Howard Road before turning nearly due north.

The two-lane highway continues through a mix of forests and farms, passing along the eastern side of Speed until reaching the outskirts of Hobgood, where it becomes the eastern terminus for NC 97 before becoming Pine Street and heading through the center of town.

The residents of Speed and Hobgood rejected the replacement of the route and brought a court case against the state, pointing towards the 1921 maps showing NC 12 running through the towns.

The highway proceeded along Howard Street, along with NC 33, and followed its present-day routing through Pinetops to Macclesfield.