It was partially cosigned in parts with US 29/70/52, US 74, NC 18, and old alignment of NC 184. NC 150 underwent numerous realignments in the 1940s and 1950s in Winston-Salem with the construction of the new "parkways" (Silas Creek Parkway, Peters Creek Parkway, Corporation Parkway). Its alignment change in Kernersville, along with its extension along Peters Creek Parkway, occurred in 1994. The segment of NC 150 through Mooresville was replaced with a northern bypass route in the late 1950s. In the 2000s (decade), NC 150 through Mooresville was widened to a four-lane boulevard, as was southern Peters Creek Parkway in southern Winston-Salem. NC 150, once signed as North and South, was converted in 1982 to its current East and West signage and description. Signage plans for the Macy Grove Road Improvements project indicate that NC 150 will be rerouted around Kernersville, continuing on US 421 (Salem Parkway) to the Macy Grove Road interchange (exit 221) and then following the under-construction northern extension of Macy Grove Road around the east side of Kernersville to rejoin the existing NC 150 alignment just north of Smith Edwards Road. The interchange between US 421 and Macy Grove Road began construction in June 2013 and opened in November 2015, and construction began on the extension of Macy Grove Road in June 2018. North Carolina Highway 150A (NC 150A) was established in 1956 when NC 150 was rerouted onto new primary routing bypassing southeast of downtown Lincolnton; the old alignment became NC 150A. The route followed West Highway 150 to Riverside Drive, where it linked-up with NC 27. In concurrency, it goes through downtown area via Main Street and Court Square Drive before linking back with NC 150 at Generals Boulevard. In 1960, NC 150A was decommissioned, leaving NC 27 through most of it and downgrade for West Highway 150 (SR 1407). North Carolina Highway 150A (NC 150A) was established between 1950-1953 as a renumbering of NC 150 along McLand Street and Main Street through downtown Mooresville. Around 1955, NC 150 was completely removed from the downtown area and NC 150A was renumbered as NC 152.