The state highway was assigned concurrent with the construction of the dam and reservoir in the early 1950s.

SR 4 begins at the North Carolina state line southwest of the community of Palmer Springs.

The roadway continues south as NC 1200 (Drewry Virginia Line Road) toward Middleburg.

SR 4 veers northwest and follows the shore of the lake to John H. Kerr Dam, on top of which the state highway crosses the Roanoke River.

[1][2] SR 4 was added to the primary state highway system in 1952;[3] the dam was completed that same year.