When completed, I-74 will link the cities of Mount Airy, Winston-Salem, High Point, Rockingham, Laurinburg, and Lumberton.

Conflicts over the routing of I-73 led to a compromise in 1995 that created a proposed extension of I-74 from Cincinnati, Ohio, to Myrtle Beach.

As of September 27, 2018[update], there are a total of 124.91 miles (201.02 km) of I-74, broken in three segments across the state: the Mount Airy, Piedmont Triad, and Laurinburg areas.

Construction completed on June 7, 2013, extended the freeway an additional eight miles (13 km) to US 220/I-73 at milemarker 86 in Randleman.

[citation needed] In late 2018, this segment was extended by 2.91 miles (4.68 km), from US 220/Haywood Cemetery Road to a partially completed trumpet interchange on US 220 north of Rockingham.

[15] On January 9, 2019, it was announced that the North Carolina State Transportation Improvement Program for 2020 to 2029 included connecting I-73 with US 74 six years sooner than planned.

[16] A $146.1-million (equivalent to $172 million in 2023[12]) contract was awarded for the 7.2 miles (11.6 km) of four-lane freeway with "substantial completion" by late 2023.

[citation needed] At Laurinburg, I-74 is to use the Laurinburg Bypass that was at the standard North Carolina freeway grade and signed as I-74 in 2008; however, the North Carolina Department of Transportation (NCDOT) had to remove the signage the following year when the FHWA ruled against using them until the freeway was up to Interstate standards.

[citation needed] Future I-74 is to continue to follow US 74, going through the city of Whiteville and bypassing the town of Lake Waccamaw.

While there are no funded projects to convert the entire highway to Interstate standards, NCDOT is funding several smaller projects to replace intersections with interchanges for several of the remaining cross streets, including for NC 72/NC 130 north of Boardman and replacing other intersections with grade separations, such as with Old US 74 near Evergreen.

[22] This would almost build a completed freeway to the NC 211 interchange in Bolton with one exception: the at-grade intersection at US 74/Creek Road (SR 2225) will be converted to an overpass in 2025 according to the NCDOT 2020–2029 STIP.

ISTEA initially authorized the new high priority transportation corridor 5, tentatively known as I-73, to travel from Michigan to South Carolina.

[citation needed] In January 2008, a 16.8-mile (27.0 km) section of freeway was completed from Candor to Ellerbe; however, it was signed Future I-73/I-74.

[34] On November 22, 2010, a 14-mile (23 km) section (known as the East Belt) was added between North Main Street in High Point to Cedar Square Road near Glenola.

[36] On June 7, 2013, I-74 extended eight miles (13 km) east onto new primary routing from Cedar Square Road to I-73/US 220, near Randleman.

[citation needed] By the middle of the following year, the Laurinburg Bypass was removed of its I-74 designation by NCDOT after a ruling from the FHWA (it was resigned as a Future I-74 Corridor).

Construction was initially scheduled for 2026 but was rescheduled for late 2019 and was planned to last three years, costing $146.1 million;[38][39] however, the completion date was pushed back due to design changes and material shortages.

[41] The bypass will also carry I-73, which will terminate at the interchange with US 74 west of Rockingham until the section of I-73 extending into South Carolina is completed.

[48][49] On September 7, 2011, North Carolina Governor Bev Perdue announced that construction of a part of the eastern leg of the beltway would begin in 2014.

[52] Since then, funding has been allocated to complete the remaining sections of NC 74 between US 52 and the current I-74 (formerly cosigned with US 311), starting with the segment between US 311 and US 158, known as Project U-2579C, in October 2017.

[56] The southbound exit and northbound entrance from US 52 was opened to traffic on November 18, 2023; the rest of the interchange remains under construction.

NCDOT conducted a feasibility study in the early 2000s to determine how to extend I-74 from Whiteville to the South Carolina state line.

The routing of the study took I-74 eastward along US 74 until it reached Bolton, where it would turn southward west of the town on a new alignment parallel to NC 211.

It would then turn southwestward at Supply and travel along the US 17 corridor before reaching the South Carolina state line.

The study, which was completed in 2005, recommended building a four-lane freeway with interchanges and service roads along this corridor.

More recently, SCDOT and NCDOT have begun coordinating a study to extend the SC 31 (Carolina Bays Parkway) to US 17.