Old Court Road connects the western and central Baltimore County communities of Granite, Randallstown, Milford Mill, Pikesville, and Towson.

Old Court Road was relocated at its eastern end in the early 1960s and in Pikesville in the late 1960s, at which time MD 133 assumed its current course.

The two-lane undivided county highway passes through farmland then has a forested descent into the narrow Patapsco River valley.

The state highway continues through farmland to its eastern terminus at an arbitrary point 3.50 miles (5.63 km) east of the Patapsco River.

Old Court Road passes along the northern edge of Milford Mill community and crosses over Interstate 695 (I-695, Baltimore Beltway) just south of its interchange with I-795 (Northwest Expressway).

The state highway carries two lanes past several farm fields between suburban subdivisions and Beth Tfiloh Dahan Community School.

The roadway continues east as Ruxton Road, which has a half-diamond interchange with I-83 (Jones Falls Expressway) that allows access to and from Baltimore.

[7][8] The macadam road was extended west to Park Heights Avenue in 1923, completing what is today the full length of MD 133.

[13][14] In 2002, a 0.09-mile (0.14 km) section of Woodstock Road immediately to the west of the Patapsco River was returned to state maintenance.