Surry County was formed in 1652, and the county seat moved frequently. This is the seventh county courthouse and the fourth to be located at the crossroads town of Surry, originally known as Scuffletown. The architect, George R. Berryman, a Surry native and graduate of George Washington University's School of Architecture, had a practice in Wilson, North Carolina. He had designed the predecessor (1907) courthouse, which burned, and this is a near duplicate except for the deletion of the cupola. Stylistically it is Jeffersonian Revival: red brick with white trim and a giant Ionic portico and full entablature recalling Pavilion V at the University of Virginia. The interior of the main courtroom, unchanged since the 1920s, includes the original judge's bench, placed within a recessed arch that constitutes the bar, and jury seating. Also on the courthouse grounds are an 1825 clerk's office
and general district court building. A 1909 Confederate memorial stood in front of the courthouse until August 2020, when it was removed.