The state highway runs 17.15 miles (27.60 km) from U.S. Route 460 (US 460) near Blackstone north to US 360 near Winterham.

SR 153 begins at an intersection with US 460 (Colonial Trail Highway) at the eastern edge of Nottoway County northeast of Blackstone.

The state highway heads north as Rocky Hill Road.

The state highway then passes through the hamlets of Earls and Wilsons Corner.

After crossing Deep Creek, a tributary of the Appomattox River, SR 153 meets the eastern end of SR 38 (Five Forks Road), which heads west to Amelia Court House, at Scotts Fork.