NC 191 begins at an intersection with US 25 Business / Asheville Highway in the city of Hendersonville in Henderson County.

Named Haywood Road, it travels northwest from Hendersonville and enters the town of Mills River, where it meets NC 280 (Boylston Highway).

The highway continues north into Venable, intersecting the eastern terminus of NC 112 (Sardis Road) and then I-26 and US 74 at exit 33 as it reaches the outermost city limits of Asheville.

At just over 21.5 miles (34.6 km), the route reaches its northern end at US 19 Business/US 23 Business (Haywood Road).

[2] North Carolina Highway 191A (NC 191A) was established as a concurrency with US 19A/US 23A along Haywood Road, between Hanover Street and Patton Avenue.