MS 23 starts at an intersection with MS 25 in the town of Smithville and travels eastward. It leaves the city limits at Seminole Road and crosses Mill Creek shortly after. The road travels through a rural area, and turns northward at George Pearce Road. Past Jug Shop Road, MS 23 crosses the Itawamba County line. Upon entering the county, the route crosses Bluff Creek and travels northeastward. At Bull Mountain Road, the road enters a forest. Traveling past the community of Turon, the road turns further north into the county. Over the next few miles, MS 23 crosses over Smith and Jims creeks and travels toward Cadamy. The road travels north past Cadamy, turning into a divided highway. It meets I-22 and US 78 at a diamond interchange, just within the corporate limits of Tremont. Past the interchange, MS 23 changes back to a two-lane road and intersects MS 178, the beginning of a short concurrency through the town.