SR 187 connects U.S. Route 13 (US 13) with Bloxom in northern Accomack County.

The state highway heads east as two-lane undivided Guilford Road to the town of Bloxom.

SR 187 veers north along Shore Main Drive, then heads east again to intersect the northern end of SR 316 (Bayside Drive) and cross an inactive railroad line.

SR 187 turns left onto Metompkin Road and passes through Modest Town before the designation ends just northeast of the community.

SR 679 continues north as Metompkin Road.