SR 151 begins in Macon County at an intersection with SR 56 in downtown Red Boiling Springs.

It goes southeastward as E Main Street to leave the town and have an interchange with SR 52.

[1] It continues southeast through farmland to cross into the southwestern corner of Clay County for a short distance before crossing into the mountains of Jackson County.

[2] SR 151 continues southeastward through the mountains along a narrow valley before entering North Springs and coming to an end at an intersection with SR 56.

[3] The entire route of SR 151 is a rural two-lane highway.