Established in 1933 as a new primary routing, it went from US 258/NC 12, near Rich Square, to NC 30 (today's US 13 Business), at Granville Street in Windsor.
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Continuing east, it crosses the Roanoke River, in concurrency with NC 45, then connects the communities of Westover and Mackeys, before ending at NC 32 in Pleasant Grove.
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At Swan Quarter, it continues at a northwesterly direction; merging with several highways along the way, including US 264, NC 99, NC 32, US 64, NC 308, and NC 461.