The first segment of MD 578 was completed in the mid-1930s; the remainder was built in the early 1940s.

Bethlehem Road continues south as a county highway.

MD 578 heads northeast as a two-lane undivided road through farmland.

After passing Newton Road, the state highway crosses Hog Creek.

[3] The remainder of the highway to Harmony, including the bridge over Hog Creek, was completed in 1941.