The state highway runs 54.58 miles (87.84 km) from SR 40 in Rocky Mount north to U.S. Route 501 (US 501) in Big Island.

[1][3] SR 122 continues north to the town of Bedford, where the highway's name changes to Burks Hill Road.

SR 122 Business heads north from its diamond interchange with the Bedford Bypass as Burks Hill Road.

Just north of the interchange, the highway passes the entrance to the Bedford Welcome Center and the National D-Day Memorial.

SR 122 turns east onto Main Street, which the highway follows for two blocks, passing the Bedford Historic Meetinghouse.