Known as Lead Mine Road, the state highway runs 3.59 miles (5.78 km) from SR 636 in Austinville east to U.S. Route 52 (US 52) in Poplar Camp.

However, it was never fully continuous; portions from Sugar Grove to Cedar Springs and west of Porters Crossroads to east of Austinville were secondary routes.

SR 69 expands to a four-lane divided highway through its diamond interchange with Interstate 77 before reaching its eastern terminus at US 52 (Fort Chiswell Road) in Poplar Camp.

These sections ran from State Route 26 (now U.S. Route 21) at Speedwell west to Cedar Springs and from SR 26 north of Speedwell east towards Porters Crossroads for 6.94 miles (11.17 km)[3] to a point west of present SR 642.

Several other pieces of SR 115 from Cedar Springs north through Rural Retreat were added in 1930 and 1932, but became State Route 90 in the 1933 renumbering; the pieces of SR 115 east of Cedar Springs, plus a proposed extension west to Sugar Grove, became State Route 91.