The state highway runs 16.17 miles (26.02 km) from SR 354 near Mollusk north to U.S. Route 360 (US 360) in Heathsville.

The state highway heads northeast as White Chapel Road and crosses Little Branch, a tributary of the Western Branch of the Corrotoman River.

There, the state highway turns north onto Court House Road.

SR 201 fully enters Northumberland County at Miskimon and has another sharp turn at Howland.

The state highway crosses the two streams that form the Great Wicomico River—Bush Mill Stream and Crabbs Mill Stream—before reaching its northern terminus at US 360 (Northumberland Highway) in Heathsville.