The state highway runs 14.313 miles (23.035 km) from U.S. Route 62 (US 62) in Conewango Township near Warren north to the New York state line in Sugar Grove Township, where the highway continues north as County Route 69 (CR 69) in Chautauqua County.

PA 69 connects Warren, Sugar Grove, and the Chautauqua Lake area.

PA 69 begins at an intersection with US 62 (Market Street Extension) in the unincorporated community of North Warren in Conewango Township.

PA 69 parallels Jackson Run, which empties into Conewango Creek, and crosses it a few times while passing through a narrow valley between Dutch Hill to the north and Yankee Bush Hill to the south.

Upon leaving the borough, PA 69's name changes to Big Tree Road for the short distance to the highway's northern terminus at the New York state line.