In Kollam, Kuriyod, Ayoor, Kottarakara and Mylom are the major towns that lie along the M C Road. The highway enters Pathanamthitta District after passing Kulakkada.
In Pathanamthitta, Kadika is the first major settlement one would come across while traveling along the state highway. The M C Road runs north-west in the district through Adoor, Kurampatta, Pandalam and Thiruvalla, chords the eastern tip of Alappuzha District, before re-entering Pathanamthitta; Chengannur is a major town that lie along the M C Road in Alappuzha District. On its way north, the highway again touches a portion of Alappuzha District before entering Kottayam.
In Kottayam District, Changanassery is the first major settlement that lie along the M C Road. Going north, the highway touches Kottayam, Ettumanoor and Kuruvalangad before entering Ernakulam District past Kulasekaramangalam.