The route begins at PA 16 in Carroll Valley in Adams County, heading northeast through rural areas and passing through Fairfield.

The road heads through forested areas with some housing developments to the west and the Liberty Mountain Resort to the east.

The route runs through a mix of fields and residential subdivisions before heading into Hamiltonban Township and turning northeast through rural areas with some commercial development.

The route heads back into Hamiltonban Township and becomes Fairfield Road again, continuing through agricultural areas with some woods and homes.

PA 116 crosses the Marsh Creek into Cumberland Township, running through more farmland before rural residential and business development.

near the Adams County Courthouse, PA 116 turns north to form a concurrency with that route for a block on Baltimore Street.

[2][3] The route crosses the Rock Creek into Straban Township and becomes Hanover Road, running near a portion of Gettysburg National Military Park as it heads into areas of woods and farms with a few homes.

The route heads back into Mount Pleasant Township and passes through more farmland with occasional development, running through Square Corner.

PA 116 runs through Brushtown and heads through a mix of farmland and residential development prior to curving northeast into the borough of McSherrystown.

[2][4] The road intersects the northern terminus of PA 516 and turns north, crossing the West Branch Codorus Creek into the borough of Spring Grove.

Farther north, the route heads into residential and commercial areas, crossing another York Railway line.

PA 116 fully enters Jackson Township, where the name becomes Hanover Road, and crosses the York Railway again, continuing northeast through agricultural areas with a few housing developments as it passes through Nashville.