The road between York and York Haven was designated as part of PA 24 in 1928. In the 1950s, US 111 Alternate (US 111 Alt.) became concurrent with PA 24 between York and I-83/US 111 in North York. PA 181 was designated between PA 250 (now US 30) in North York and PA 382 in York Haven in 1961 after the north end of PA 24 was truncated to east of York; I-83 Bus. also replaced US 111 Alt. The section of the route between US 30 and I-83 became a divided highway in 2003.