The start of the road is just about one-half mile (0.80 km) from the Oak Island lighthouse, a tourist attraction in the area.

Running north along Country Club Drive, NC 133 crosses the Intracoastal Waterway on the G. V. Barbee Bridge.

North of the intersection, NC 133 continues northeast along Long Beach Road SE for 1.7 miles (2.7 km).

The border of Military Ocean Terminal Sunny Point coincides with the eastern side of the road in this area.

Following the boundary of Military Ocean Terminal Sunny Point, NC 133 bears to the northeast until it nears Liliput Creek where it turns to the northwest.

Access to Orton Plantation and Brunswick Town State Historical Site is located off of NC 133 north of Sunny Point.

US 74 and NC 133 turn east from the north-south road and cross the Northeast Cape Fear River via the Isabel Stellings Holmes Bridge.

NC 133 and US 117 both run through Castle Hayne and cross over the Northeast Cape Fear River, entering Pender County.

[1] North Carolina Bicycle Route 5 runs concurrently along NC 133 from the northernmost US 17/US 421 intersection, across the Isabel Holmes Bridge, to Third Street in Wilmington.

[5] The routing of modern-day NC 133 was established in 1916 when North Carolina created a highway running from Wilmington, through Castle Hayne and Bells Crossroads, towards Clinton.

[11] A 24-mile (39 km) segment between Belville and Southport first appeared on North Carolina maps beginning in 1941 as an unnumbered gravel-topsoil road.

South of Liliput Creek, the road followed an eastern route, which ran parallel to the Cape Fear River and followed East Moore Street into Southport.

Following the establishment of Military Ocean Terminal Sunny Point, NC 40 was rerouted along new routing along the western edge of the installation.

[17] The highway was extended south from Southport to Oak Island in 1960, running concurrently along NC 211 for 1 mile (1.6 km).

[27] The Wilmington Urban Area Metropolitan Planning Organization (WMPO) has identified three projects to be completed along NC 133 in New Hanover and Brunswick Counties.

A widening project along Castle Hayne Road, between US 74 (Martin Luther King Jr. Parkway) and I-140 is planned to begin construction in 2030.

Additionally, the WMPO plans for the creation of a flyover interchange at the current intersection between NC 133, US 74, and US 421 west of the Isabel Holmes Bridge.