The state highway runs 72.23 miles (116.24 km) from U.S. Route 33 and US 250 in Richmond, Virginia east to Chesapeake Boulevard in Stingray Point.

SR 33 begins at an intersection with US 33 and US 250 (Broad Street) in the city of Richmond adjacent to the Siegel Center, the home of the Virginia Commonwealth University Rams basketball teams.

[1][2] SR 33 leaves the downtown area on the four-lane with side bicycle lanes divided Leigh Street Viaduct, officially marked as the Martin Luther King Jr. Memorial Bridge, which passes over I-95, US 360, and CSX's Richmond Terminal Subdivision.

The state highway turns east onto Nine Mile Road and leaves the city of Richmond at its partial cloverleaf interchange with I-64.

[1][2] SR 33 passes through the I-64 interchange as a four-lane divided highway, then continues as a five-lane road with center turn lane toward the Henrico County suburb of Highland Springs.

The two highways reduces to an undivided four-lane road and meet the northern end of SR 273 (Farmers Drive) in the village of Eltham.

[1][2] The two highways cross Dragon Swamp, a tributary of the Piankatank River, into Middlesex County and diverge just south of Saluda.

SR 33 runs concurrently with U.S. Route 17 Business on the two-lane Gloucester Road to the center of the unincorporated town, where the state highway turns east onto School Street.

SR 33 continues east through Deltaville to the eastern end of the peninsula between the Rappahannock and Piankatank Rivers at Stingray Point.