One segment begins near Flippin and runs east across Bull Shoals Dam to downtown Mountain Home.

It runs north into Flippin, becoming a two-lane road with a center turn lane,[3] passing Hickey City Park, and bridging Fallen Ash Creek.

It runs along the western edge of downtown Flippin before bridging the Missouri and Northern Arkansas Railroad tracks.

[5] East of the state park, Highway 178 passes the regionally known Gaston's White River Resort, followed by the small town of Lakeview.

Following the ribbon cutting, Truman and the presidential motorcade traveled along Highway 178 to Flippin en route to Cotter.

[11] The second segment was created on June 28, 1973 between Mountain Home and the Buzzard Roost Use Area pursuant to Act 9 of 1973 by the Arkansas General Assembly.

[14] The highway remained unchanged since 1974 until an extension through Flippin following construction of a new terrain route of US 62 bypassing the town.