MD 545 was constructed to Little Elk Creek near Childs in the early 1930s and extended to Pleasant Hill in the late 1940s.

MD 545 parallels the creek to the road's narrow, curved passage under CSX's Philadelphia Subdivision rail line as it enters the village of Childs.

[3][4] This work included the construction of a 27-foot-wide (8.2 m) steel pony truss bridge over Little Elk Creek that was completed in 1932.

[8] In January 2010, the Maryland State Highway Administration put the 1932 pony truss bridge MD 545 used to cross Little Elk Creek up for sale to any buyer willing to preserve the bridge at a new location.

[5] No interested party was found, so the old bridge was demolished in June and July 2011.