The 1,300-kilometre-long (808 mi) road, constructed as a sealed two-lane single carriageway, travels through remote and largely arid landscapes.

Economic growth and development in northern Western Australia prompted initial improvement efforts in the late 1940s, and a sealed road was constructed from Geraldton to Carnarvon by 1962.

The impact of cyclones and seasonal flooding resulted in a realignment inland of the Carnarvon to Port Hedland section, which was constructed and sealed between 1966 and 1973, and required thirty new bridges.

Apart from Whim Creek, between Roebourne and Port Hedland, roadhouses serving the highway are the only settlements on the long stretches of rangeland expanses between these towns.

It heads east from the interchange and curves round to the north, past a traffic-light intersection with Geraldton–Mount Magnet Road.

The highway continues north through Geraldton's outer suburbs for eight kilometres (5 mi) before the landscape transitions to scrubland.

East of the town, the landscape near the river features banana and other horticultural plantations,[15] while the vegetation in the surrounding region is primarily shrublands.

[16] The highway skirts east of Carnarvon, and crosses the Gascoyne River nine kilometres (6 mi) north-east of Robinson Street, the main road into the town.

Forty kilometres (25 mi) east, Roebourne is the gateway to Wickham, Point Samson and the ghost town of Cossack.

[19] Western Australia's Nomenclature Advisory Committee[b] proposed in October 1940 that a highway name be used to describe the main route from Midland to Geraldton,[21] and extending to areas further north.

[2] However, the highway was mostly a series of tracks through remote pastoral areas, with the sealed road ending just past Northampton, approximately 50 kilometres (31 mi) north of Geraldton.

[17]: 120–121 Economic growth and development in Western Australia's northern regions in the 1940s prompted the state to quadruple road funding between 1946 and 1952.

Given the vast distance the highway travelled, and destructive cyclones in the Pilbara and Gascoyne that could destroy multiple weeks worth of work, the overall improvement was relatively insignificant.

Many floodways were completely washed away, and North West Coastal Highway was immersed in flood water for 60 miles (97 km) either side of Onslow.

[17]: 184–185 By the 1960s North West Coastal Highway had become a crucial connection for development in the Pilbara – including the pastoral industry, tourism, and the emergence of iron ore mining.

Locally available material was used to great extent during construction, with techniques adjusted based on what was available; however, some resources were transported across vast distances.

The project required thirty bridges, over riverbeds that could be dry all year, but might receive as much as 1,300 millimetres (51 in) of rainfall in three months, as had been the case at Onslow in 1961.

In August 1988, work on upgrading five and a half kilometres (3.4 mi) of North West Coastal Highway was completed, the final section between Geraldton and Carnarvon to have been brought up to standard.

Sections washed away by floods in January 2003 were rebuilt, and opened in October of that year, and repairs to the damage from Cyclone Monty in March 2004 were completed that November.

[28]: 125–127 The biggest individual project in this period, across all of rural Western Australia, was Stage 1 of the Geraldton Southern Transport Corridor.

[31] In 2013 work began on a project to seal the highway's shoulders from Yannarie River at Barradale to the Onslow turn-off; it is expected to be completed by mid-2015.

[32] Further work to widen the highway between Minilya and Barradale, including replacing two floodways with bridges, is expected to be completed by the end of 2017.