Known as Budds Creek Road, the state highway runs 19.02 miles (30.61 km) from U.S. Route 301 (US 301) in Allens Fresh east to MD 5 in Leonardtown.

The state highway heads east as a two-lane undivided road that crosses over CSX's Popes Creek Subdivision railroad line and passes through the hamlet of Allens Fresh.

MD 234 crosses Allens Fresh Run, a tributary of the Wicomico River, as the stream flows out of the southern end of Zekiah Swamp, which is preserved within Zekiah Swamp Natural Environment Area.

[1][2] MD 234 curves southeast through the hamlet of Budds Creek, where the highway meets the southern end of MD 236 (Thompson Corner Road) and passes north of three motorsports facilities: Maryland International Raceway, Budds Creek Motocross, and Potomac Speedway.

The state highway crosses Saint Clements Creek and heads east through farmland, crossing Nelson Run right before the highway reaches its eastern terminus at MD 5 (Point Lookout Road) on the western edge of Leonardtown.

[5] The original course of MD 234 was completed when the gap between Chaptico and the county line at Budds Creek was filled in 1925.

[10][11][12] The first upgrade of MD 234 was a relocation at Allens Fresh Run, which included replacing a dangerous one-way bridge over the stream, that was completed in 1933.

[22][23] In September 2011, MD 234's bridge over Allens Fresh Run was washed out by flooding of the creek due to torrential rainfall from the remnants of Tropical Storm Lee.