The state highway runs 15.47 miles (24.90 km) from U.S. Route 17 (US 17) in Chesapeake north to US 60 in Virginia Beach.

The state highway heads north as Bainbridge Boulevard, a two-lane undivided road that parallels the river through an industrial area.

SR 166 follows the four-lane divided street along the western edge of the Norfolk State University campus and intersects US 58 (Virginia Beach Boulevard) before turning onto four-lane undivided Princess Anne Road, which heads west as SR 404.

SR 168 has a grade crossing of Norfolk Southern's rail line to Sewell's Point and expands to a divided highway as it passes along the northern edge of an industrial area, where the highway meets the southern end of SR 194 (Sewells Point Road).

SR 166 and US 13 continue east across Lake Wright and meet I-64 (Hampton Roads Beltway) at a partial cloverleaf interchange.