Labeled as a north–south route, NC 87 travels along a relatively straight southeast–northwest path, connecting Cape Fear region with the Piedmont.

It is also the main north-south route connecting the cities of Fayetteville, Sanford, Burlington and Reidsville.

In Sanford, it intersects US 421, on which users can travel east to Lillington, or northwest to Greensboro, and Winston-Salem.

The highway remains four-lane through downtown Burlington, returning to mostly two lanes for the remainder of its route in North Carolina, save for Reidsville, where it intersects US 29, and runs on four-lane commercial corridor Freeway Drive.

North Carolina Highway 87 Alternate (NC 87A), was established between 1940-44 as a new primary routing.

The request to establish a bypass was pushed by the Sanford City Council and Lee County.