The highway travels in a north–south orientation between the South Carolina state line to Lumberton, then switches to an east–west orientation connecting the cities and towns of Elizabethtown, White Lake, Harrells, Wallace, Beulaville and Trenton.

Upon establishment, the highway began in Wallace and continued 1 mile (1.6 km) east to intersect US 17-1 and NC 40 in Tin City.

The highway continued northeast for 20 miles (32 km) through Chinquapin before intersecting NC 24 in Beulaville.

In Elizabethtown, NC 41 began to run concurrently alongside US 701 until meeting its former terminus in White Lake.

[6] The segment west of the South River to US 701 was upgraded to a topsoil, sand-clay, or gravel road by 1936.

By 1940, the highway was paved between Tin City and the Northeast Cape Fear River and along a section in Jones County between its eastern terminus and an area east of Comfort.

Much of the former route became an extension of NC 411 while the remainder was downgraded to a secondary road known as Harrells Highway.

[17] Despite NCDOT rerouting NC 41 away from the bypass in Elizabethtown, no signage was updated to reflect the new routing.