The highway begins at U.S. 75 east of Beggs and travels west to that town, where it turns north.

In Sapulpa, its northern terminus is explicitly signed at an intersection with State Highway 66 and other state highways, but official Oklahoma Department of Transportation maps show it extending northeast along SH-66 until the point where it merges with I-44.

On August 28 of that year, mainline U.S. 75 was rerouted onto the new Okmulgee Beeline freeway and expressway, and U.S. 75 Alternate was established along the former route of the highway.

The entire route is in Sioux City, Woodbury County.

The entire route is in Le Mars, Plymouth County.