PA 174 begins at an intersection with US 11/PA 533 in the borough of Shippensburg, heading east on two-lane undivided Walnut Bottom Road.

The route fully enters Shippensburg Township and passes more businesses along with some fields, reaching a diamond interchange with I-81.

Past the I-81 interchange, PA 174 continues into Southampton Township and heads into agricultural areas with sparse homes, passing through the community of Lees Cross Roads.

At this point, the route begins to run a short distance to the north of Norfolk Southern's Lurgan Branch.

The road heads into South Newton Township and becomes West Main Street, turning northeast and passing rural areas of homes in the communities of New Lancaster and Brookside.

The route continues through more open areas of agriculture as it passes through the communities of Hockersville and Centerville, reaching an intersection with PA 233 after the latter.

The route heads into South Middleton Township and crosses PA 34, becoming East Old York Road at that point.

The road continues east and passes through the residential community of Boiling Springs on 1st Street, where it follows the Appalachian Trail for a short distance.