PA 865 begins at an interchange with
I-99/
US 220 in
Antis Township,
Blair County, heading west on Old U.S. 220, a two-lane
divided highway. The road runs through wooded areas and crosses
Little Juniata River, coming to an intersection with
US 220 Business. Past this intersection, the route becomes two-lane undivided Campbells Lane and passes homes and a few businesses, heading into the borough of
Bellwood. Here, PA 865 becomes East Logan Street and heads west-northwest past residences, turning west and passing over
Norfolk Southern's
Pittsburgh Line. The route turns northwest onto North Tuckahoe Street and runs past more homes along with a few commercial establishments. The road heads back into Antis Township and continues through rural residential areas, passing through Roots Crossing. PA 865 passes a few forested fields before passing Bellwood Reservoir and heading into densely forested areas, turning to the north. PA 865 enters
Reade Township in
Cambria County and becomes Skyline Drive, continuing north through more forests and passing through Lloydville. The road turns to the southwest and runs through the residential community of
Blandburg before heading through more wooded areas with some fields and homes, curving north again. The route passes through
Mountaindale and heads northwest, coming to an intersection with
PA 253 in Glasgow. At this point, PA 253 turns northwest to form a
concurrency with PA 865, passing a few homes. PA 253 splits from PA 865 by turning east onto Executive Drive, with PA 865 winding northwest through woodland with a few agricultural clearings. PA 865 continues into
Beccaria Township in
Clearfield County and becomes Heverly Boulevard, heading north through more woods with occasional farm fields. After passing through Utahville, the route turns to the west and heads through forested areas, passing through Heverly. Farther west, PA 865 reaches its northern terminus at an intersection with
PA 53 on the southern border of the borough of
Coalport. ==Major intersections==