The route runs through seven counties on its approximately 155-mile (249 km) trip through the region.

It then continues as a two-laned road through residential areas of East Liverpool.

[3][4] In 1927 the highway was extended to the current eastern terminus at the Pennsylvania state line, along mostly the former route of SR 20.

[5][6] The route was extended to its current northern terminus at SR 103, in 1939.

[9][10] In 1974, the route between Wellsville and East Liverpool was upgraded to a four-lane highway.