It travels high into the mountains along a scenic stretch of the upper West Fork of the Pigeon River, and intersects the Blue Ridge Parkway at Beech Gap at an elevation of approximately 5,300 feet (1,600 m).

Between US 64 and intersection of Macedonia Church Road (SR 1326), the highway has seven miles of narrow, winding, hairpin turns that are mostly surrounded by the Pisgah National Forest.

Northward beyond Macedonia Church Road, the highway has broader shoulders and has entered Balsam Grove, and serves as the primary route in and out of the area.

After passing through Balsam Grove, the road returns into Pisgah National Forest, climbing rapidly for another 7 miles (11 km) through the Pinhook Valley, peaking at the intersection with the Blue Ridge Parkway at 5,300 feet (1,600 m).

Along the way, you will find several spots to pull over to the side of the road to take a break from the curves, allow faster traffic to move on, or to provide relief for a carsick passenger.