PA 234 begins at an intersection with US 30 in Franklin Township, Adams County, heading north on two-lane undivided Buchanan Valley Road. The road runs through farms and forests with some homes, turning northeast and passing through Trust. The route continues through rural areas as it curves more to the east and winds through forests along the Conewago Creek, eventually crossing the creek into Menallen Township. PA 234 continues southeast a short distance to the northeast of the creek on Narrows Road. The road crosses the creek again and heads back into Franklin Township, passing through Bridgeport and heading east before turning south in agricultural areas with a few homes. The route enters the borough of Arendtsville and becomes North High Street, passing homes. PA 234 turns east onto Main Street and continues through more residential areas. The road crosses the Conewago Creek into Butler Township and becomes Arendtsville Road, running through open farmland with a few homes. The route heads into the borough of Biglerville and intersects the western terminus of PA 394, becoming West York Street and passing residences. The road becomes East York Street and crosses PA 34, continuing east and crossing the Gettysburg and Northern Railroad at-grade.^[2][3]

PA 234 turns northeast and heads back into Butler Township, becoming Heidlersburg Road and running through more open agricultural areas with occasional homes. The road curves more to the east and crosses into Tyrone Township, running through more rural areas. The route passes through Heidlersburg and continues to an interchange with the US 15 freeway. From here, PA 234 runs through a mix of farmland and woodland with some residences on East Berlin Road, becoming the border between Huntington Township to the north and Tyrone Township to the south as it heads through Five Points. From this point, the road becomes the border between Reading Township to the north and Tyrone Township to the south, briefly heading entirely into Tyrone Township prior to crossing the Plum Run into Reading Township. In this area, the route intersects PA 94 before continuing east through more agricultural areas. PA 234 crosses the Conewago Creek into the borough of East Berlin and becomes West King Street, passing homes along with a few businesses. In the center of town, the route intersects PA 194 and becomes East King Street.^[2][3]

PA 234 crosses into Paradise Township in York County and becomes East Berlin Road, heading east through more farmland with a few homes. The road runs through more rural areas as it passes through Jackson Township. The route briefly passes through Dover Township before crossing the Honey Run into West Manchester Township. In this area, PA 234 runs through more agricultural areas as it passes to the north of a quarry. The road comes to a bridge over the US 30 freeway and heads into industrial areas. Farther east, PA 234 heads into residential areas and comes to its eastern terminus at PA 462 just outside the borough of West York.^[2][4]

When routes were legislated in Pennsylvania in 1911, present-day PA 234 was not given a number. By this time, the road between Arendtsville and Biglerville was paved.^[5] PA 234 was designated in 1928 to run from US 30 in western Adams County east to PA 194 in East Berlin. At this time, the route was paved between US 30 and the eastern edge of Biglerville while the section between Biglerville and East Berlin was unpaved.^[6] By 1930, the route was under construction between US 15 (Old Harrisburg Road) in Heidlersburg and PA 194 in East Berlin.^[7] In 1937, PA 234 was extended east from PA 194 in East Berlin to US 30 (now PA 462) west of West York.^[8][9] The entire length of the route was paved in the 1930s.^[9]

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• Pennsylvania Highways: PA 234