The highway beings on Falls Road at northbound U.S. Route 301 Business in Rocky Mount.

The overlap with NC 43 begins just south of an interchange with US 64 at Exit 468B, where the street becomes Benvenue Road entering the Golden East section of the city.

The primarily rural setting is replaced by industrial zoning and then a series of motel franchises as the road approaches the intersection with NC 4 across from Exit 145 the trumpet interchange with Interstate 95.

Further north the routes approach a bridge that crosses the Fishing Creek, and thus the Nash-Halifax County Line.

Between the Julian R. Allsbrook Highway and East 14th Street, the road crosses a former Seaboard Air Line between two stations, and part of a wye leading to the WestRock Paper Mill.

The spur to that mill is crossed again at the Washington Street Extension just south of the Roanoke Canal Museum and Trail.

After passing by a small trucking company on the south side, it curves more towards the east, still remaining rural.