Pennsylvania Route 74

York County

PA 74 begins at the Maryland state line (Mason–Dixon line) in Peach Bottom Township as Delta Road, picking up where Maryland Route 165 leaves off. Two miles to the north, just outside the borough of Delta, PA 74 intersects the eastern terminus of Pennsylvania Route 851 at a roundabout. PA 74 then continues north into Lower Chanceford Township, after which it shifts to a northwest direction and meets with the western terminus of Pennsylvania Route 372 south of Sunnyburn. Three miles to the north in Airville, PA 74 has a short wrong-way concurrency with Pennsylvania Route 425. After PA 425 splits off, PA 74 continues shifting to the north and west, and passes through Chanceford and Windsor townships before entering the borough of Red Lion. In downtown Red Lion, PA 74 becomes known as Broadway and intersects Pennsylvania Route 24 then shifts slightly toward the south, and then back west. Just west of Red Lion, PA 74 enters Dallastown and intersects the eastern terminus of Pennsylvania Route 214. It then enters York Township, makes a 30-degree turn toward the northwest and intersects the eastern terminus of Pennsylvania Route 182.

Just outside York, as Queen Street, PA 74 intersects Interstate 83 at exit 16. It then continues north into York passing by York's FOX 43 television station. Then, PA 74 intersects College Avenue, after which it makes a left turn toward the north to begin a concurrency with Pennsylvania Route 462. PA 74 north/PA 462 west are called Philadelphia Street and PA 74 south/PA 462 east are called Market Street; both streets are one-way and run parallel to each other. After crossing the Codorus Creek, PA 74/PA 462 have entered downtown York. In downtown York, PA 74/PA 462 intersect Interstate 83 Business (George Street). Then, the west lanes of PA 462 split from PA 74 north, ending the concurrency of the two routes. As PA 74 leaves York, it passes north of York County Agricultural Society Fairgrounds.

Between West York and Shiloh, PA 74 intersects U.S. Route 30 at a diamond interchange. In Shiloh, as Carlisle Road, PA 74 intersects the western terminus of Pennsylvania Route 238, and then continues northwest into the community of Weigelstown and the borough of Dover. In Dover, PA 74 is called Main Street and intersects the western terminus of Pennsylvania Route 921. North of Dover, once again known as Carlisle Road, PA 74 passes west of Gifford Pinchot State Park and then meets the southern terminus of Pennsylvania Route 177 just northeast of the borough of Wellsville. PA 74 makes a left turn to the southwest and passes through Wellsville as Main Street, and then turns back towards the northwest as it exits the borough. PA 74 has a couple of turns in Warrington Township. South of Dillsburg, PA 74 makes a turn toward the northwest becoming Baltimore Street and intersects the northern terminus of Pennsylvania Route 194. In Dillsburg, PA 74 has a short concurrency with U.S. Route 15. North of the US 15 concurrency, PA 74 heads north and exits York County as York Road.

Cumberland County

PA 74 enters Cumberland County in Monroe Township, where it intersects Pennsylvania Route 174. PA 74 continues as a straight road until it intersects Interstate 81 at exit 48 in South Middleton Township. PA 74 only has access to the southbound lanes of I-81. Southeast of Carlisle, PA 74 makes a 40-degree-angle turn towards the southeast to merge with Pennsylvania Route 641, which provides access to I-81 northbound, to begin a wrong-way concurrency. At the center of Carlisle, PA 74 continues its concurrency with PA 641 heading towards the west as High Street, with U.S. Route 11 shortly joining the concurrency after splitting from Pennsylvania Route 34. Then PA 74 splits from US 11 and PA 641, goes north for about two-thirds of a mile as College Street, and then makes a 90-degree left turn to the west as B Street to leave Carlisle. At the Carlisle borough line, PA 74 passes under Interstate 76, the Pennsylvania Turnpike and then enters a mountainous region, in which the route remains until it ends. In North Middleton Township, PA 74 is called Waggoners Gap Road and intersects Pennsylvania Route 944. At and near the Cumberland-Perry county line, PA 74 has very sharp and dangerous S-curves as it heads toward Blue Mountain.

Perry and Juniata counties

Along one of the curves mentioned above, PA 74 enters Perry County and then crosses Blue Mountain. In the village of Alinda, PA 74 intersects Pennsylvania Route 850. South of Pennsylvania Route 274, PA 74 has a couple of curves. While meeting with PA 274 in Spring Township, PA 74 turns back toward the northwest. It then heads to the north and soon shifts to the northeast. Then in Saville Township, PA 74 makes a 90-degree-angle turn when it meets the western terminus of Pennsylvania Route 849. PA 74 then shifts toward the northwest and intersects Pennsylvania Route 17 in the village of Ickesburg. After that, the route shifts toward the north and then back northwest once more, and then enters Juniata County. PA 74 has more than 5 S-curves in Juniata County before straightening out. PA 74 ends at an intersection with Pennsylvania Route 75 in Turbett Township.