The state highway heads northeast from SR 47 as Gethsemane Church Avenue, then becomes unnamed after leaving the town limits.

The state highway begins to parallel a Norfolk Southern Railway rail line as it approaches Keysville.

SR 59 enters the town of Keysville as Merry Oaks Drive then reaches its northern terminus at SR 40 (Church Street) west of downtown Keysville.

Until 1957, when it was transferred from the secondary system, SR 59 was State Route 657.

The number 657 is now used on Bradner Road, a minor 0.8-mile (1.3 km) dead-end street off SR 649 east of Phenix.