An earlier Route, also named Spur 122, was designated on July 1, 1941, from U.S. Highway 60 to SH 86 in Bovina.

Spur 122 follows the original routing of U.S. Highway 181 on the southeast side of San Antonio.

[3] Spur 122 begins near the city limits on the southeast side of San Antonio at US 181.

The road continues towards the northwest passing over I-410 before turning towards the north to parallel the San Antonio River to its west.

The highway also passes near the western boundary of Brooks City-Base, a former U.S. Air Force installation.