The highway begins to parallel the Spokane River as it passes a golf course and then through the community of Nine Mile Falls.

It then climbs and shifts further north of the river to accommodate a housing development at Suncrest.

In 2009, WSDOT calculated that as few as 360 cars traveled through the intersection with Corkscrew Canyon Road near the northern terminus, and as many as 30,000 cars passed through the intersection with Ash Street in downtown Spokane.

A study by the Washington State Department of Highways was completed in 1968 and determined that it would cost $15 million and would be "difficult to justify" due to its low traffic.

[5] The Spokane–Nine Mile Falls section of SR 291 was widened and modernized in 1970 by the state government, which included the realignment of an intersection with North Assembly Street.