WV 218 begins at a junction with US 19, in Marion County, just east of Worthington. From its southern terminus it the route runs northerly along Helens Run for about until it reaches Idamay. From that census-designated place, the route continues northerly for about, until it reaches U.S. Route 250 in Farmington. Within the town of Farmington, WV 218 runs easterly for a short along the south bank of the Buffalo Creek and concurrent with US 250 before heading north. After crossing the creek, the route continues northerly along the Little Laurel Run through town and beyond, for about. About north of headwaters of the Little Laurel Run, WV 218 reaches the west bank of Dunkard Mill Run. After running a short distance along the west bank, the route crosses that stream just above its confluence with Little Dunkard Mill Run Heading north the route crosses Little Dunkard Mill Run and then continues northerly for about along the streams east bank, past its headwaters, until it turns easterly and reaches Basnetteville. In Basnettville, WV 218 crosses the Paw Paw Creek and then turns briefly northwest for about, along the northwest bank of the Paw Paw Creek, on its way to Fairview and is named Paw Paw Creek Road. Once it reaches Fairview, the route is signed as Main Street, until it crosses Bennefield Prong and turns north again. Continuing northerly, and signed as Jefferson Street, the route crossed back over Bennefield Prong and the runs along its east bank. North of Fairview the route is named Daybrook Road. It runs northerly and then northeasterly until it leaves Marion County and enters Monongalia County. Continuing northeasterly along the east bank of Bennefield Prong, WB 218 passes the stream's headwaters turn north once again to run northerly until it reaches the south bank of Dunkard Creek, Just east of Blacksville. The route then turns west to run concurrently with West Virginia Route 7. A few blocks after entering Blacksville, the route turns north one more time, ending its concurrency with WV 7. Continuing northerly, the route arrives at its northern terminus at the northern city limits of Blacksville within a few more blocks. The city limits are at the West Virginia-Pennsylvania state line. The road continues north as Pennsylvania Route 218 towards Spraggs and Waynesburg.
