SC 174 travels generally in a south–north direction. Beginning at an intersection with U.S. Highway 17 approximately 25 miles west of Charleston, SC 174 crosses over the CSX Railway and passes through the rural community of Adams Run. After passing the intersection of White Point Rd, the route's National Scenic Byway designation begins as it crosses expansive marshes and over the North Edisto River onto Edisto Island.
Once upon Edisto, SC 174 travels in a meandering direction under an ancient live oak canopy and past small homes, prayer chapels, churches, and country stores. SC 174 serves as the primary spine road for the island, with smaller country roads and lanes intersecting the route, leading to more distant areas of the island. Upon reaching the Edisto Beach town limits, the road enters into Colleton County and crosses over another marsh area before sharply turning to the southwest and paralleling the Atlantic shore. For most of the route, SC 174 is a two lane road, although it is a four lane configuration in Edisto Beach.