PA 475 begins at an intersection with US 522 in Dublin Township, Fulton County, heading west on two-lane undivided Waterfall Road.

The road passes through a mix of farmland and woodland, turning to the north before heading northwest and coming to a bridge over I-76 (Pennsylvania Turnpike).

At this point, the road continues a short distance west as State Route 4014 (Pitt Street) to connect to PA 655 and PA 475 turns northeast onto North Clear Ridge Road, becoming the border between Taylor Township to the west and Dublin Township to the east.

[3][4] PA 475 crosses into Springfield Township in Huntingdon County, becoming an unnamed road and heading into forested areas, curving to the east before a turn back to the north.

PA 475 enters Cromwell Township and runs farther east from the creek, heading through woodland with some farms and homes.