The western terminus is at West Virginia Route 29 near Forks of Cacapon in Hampshire County.

Gaston Road (CR 45/7) serves as a cut-off road between WV 29 and WV 127, and its one-lane arched bridge crosses the North River shortly before its confluence with the Cacapon.

At a gap in Bear Garden Mountain (1572 ft), WV 127 curves eastward through the community of Good, then straddles the border between Hampshire County and Frederick County, Virginia.

As a vestige of this, all secondary routes branching off of both roads have 45 as their numerator.

Media related to West Virginia Route 127 at Wikimedia Commons