The state highway runs 19.23 miles (30.95 km) from SR 3 in White Stone north to U.S. Route 360 (US 360) at Burgess.

The state highway heads west as Chesapeake Drive, which becomes Irvington Road on leaving the town.

SR 200 crosses the Eastern Branch of Carter Creek into the town of Irvington, where the highway curves north.

The state highway leaves the town and passes through the hamlet of Pitmans Corner, the site of historic Christ Church.

[1][2] SR 200 continues north along Church Street and roughly follows the height of land between the direct Chesapeake Bay drainage on the east and the watershed of the Corrotoman River, a tributary of the Rappahannock River, on the west; the drainage boundary also forms the boundary between Lancaster and Northumberland counties.