SR 174 begins at an intersection with US 220 Business (Virginia Avenue) in Collinsville.

SR 174 becomes a divided highway as it curves east and passes by the Henry County offices and courthouse.

The state highway curves south and intersects SR 108 (Figsboro Road) and SR 714 (College Drive), which serves Patrick & Henry Community College and several industrial parks.

South of Beaver Creek Plantation, SR 174 becomes a three-lane road with a center left-turn lane and enters the city of Martinsville as Liberty Street.

The state highway passes under the Dick & Willie Passage Rail Trail before reaching its eastern terminus at SR 457 (Commonwealth Boulevard) north of downtown Martinsville.