SR 122 begins at an intersection with SR 40 on the east side of the town of Rocky Mount, the county seat of Franklin County. The state highway heads northeast as two-lane Booker T. Washington Highway. SR 122 crosses the Blackwater River, a tributary of the Roanoke River, and the former river's tributary, Maggodee Creek, before meeting the southern end of SR 116 at Burnt Chimney. The state highway continues east by Booker T. Washington National Monument, which preserves the birthplace of Booker T. Washington. SR 122 passes through the community of Westlake Corner, a commercial center for the western side of Smith Mountain Lake, before crossing the lake and entering Bedford County. The state highway continues north as Moneta Road through the village of Moneta, where the highway crosses over Norfolk Southern Railway's Altavista District. SR 122 crosses Goose Creek and intersects SR 24 west of Body Camp; SR 24 heads west as Stewartsville Road toward Stewartsville and east as Shingle Block Road. SR 122 continues north to the town of Bedford, where the highway's name changes to Burks Hill Road. At the highway's diamond interchange with the Bedford Bypass, the road continues toward downtown Bedford as SR 122 Business while SR 122 joins US 460 and US 221 on the four-lane freeway bypass. The three highways head east to a diamond interchange at the east end of the four-lane divided bypass. US 460 continues east as Lynchburg Salem Turnpike toward Lynchburg while SR 122, US 221, and US 460 Business follow Main Street west for one block. There, US 460 Business continues toward downtown Bedford while SR 122 and US 221 turn north onto two-lane Independence Boulevard, an eastern bypass of Bedford that crosses over Norfolk Southern's Blue Ridge Districtrail line. SR 122 and US 221 diverge at the northern end of Independence Boulevard, where the highways meet the northern end of SR 122 Business. US 221 heads east on Forest Road toward Forest while SR 122 heads north on Longwood Avenue out of the town of Bedford. SR 122 continues north as Big Island Highway through the hamlet of Centerville, which contains the historic home Otterburn, and over the Big Otter River. The state highway passes between Suck Mountain and Hurricane Mountain before reaching its northern terminus at US 501 just north of the village of Big Island on the James River.
Major intersections
Bedford business route
Virginia State Route 122 Business is a business route of SR 122 within the town of Bedford. The highway runs from SR 122, US 221, and US 460 on the south side of Bedford to SR 122 and US 221 on the north side of Bedford. SR 122 Business heads north from its diamond interchange with the Bedford Bypass as Burks Hill Road. Just north of the interchange, the highway passes the entrance to the Bedford Welcome Center and the NationalD-Day Memorial. At King Street, the highway's name changes to Crenshaw Street, which the business route follows to US 460 Business. SR 122 turns east onto Main Street, which the highway follows for two blocks, passing the Bedford Historic Meetinghouse. The business route turns north onto Bridge Street, where the highway leaves its concurrency with US 460 Business and joins SR 43 to cross over Norfolk Southern Railway's Blue Ridge District. When SR 43 heads northwest as Peaks Street toward the Peaks of Otter, SR 122 Business heads northeast along Longwood Avenue to its northern terminus at US 221 and SR 122, which heads south with US 221 on Independence Boulevard and north as Longwood Avenue.
