The portion of the route between Dimock Corners and Herrick Center was originally a private turnpike called the Cohecton and Great Bend Turnpike that was chartered in 1804 and completed in 1811. The current alignment of the route was paved in the 1930s and 1940s. Between the 1930s and 1954, the section between Dimock Corners and Herrick Center was designated as part of PA 371. PA 374 was created in April 1961 as one of five state highways designated to interchange with the newly constructed I-81. The route originally ran between PA 92 in Glenwood and U.S. Route 106 (US 106, now PA 106) in Royal. PA 374 was extended east to its current terminus in the 1980s.