It follows Pine Avenue through downtown Niagara Falls, spanning 2.12 miles (3.41 km) between New York State Route 104 (NY 104) at its western terminus and US 62 at its eastern extent.

NY 18 was truncated to Lewiston, a village north of the city, in the early 1960s, making US 62 the sole occupant of Pine Avenue.

Between 10th and Portage Road, a local north–south arterial, US 62 Business passes along the northern edge of the Niagara Falls Memorial Medical Center.

Although this area is mostly commercial as well, it features decorative elements not found west of Portage Road, such as stylized streetlights alongside the roadway.

The district extends for 1.25 miles (2.01 km) eastward to Hyde Park Boulevard (NY 61), where another overhead sign denotes the eastern edge of Little Italy.

[4] Pine Avenue in Niagara Falls was originally designated as part of NY 34 when the first set of posted routes in New York were assigned in 1924.