Interstate 74 in North Carolina

Southern terminus of the Mount Airy segment of I-74. Pilot Mountain can be seen in the background.

The first section of I-74 begins at the Virginia state line (overlapped with I-77 for approximately 4 miles (6.4 km). After separation, it goes east and connects to US 52 near Mount Airy, where the first section ends.

I-74 is to be routed along US 52 from Mount Airy to Bethania, where it will then separate onto the new Winston-Salem Northern Beltway and go east around Winston-Salem before connecting to existing I-74 south of Kernersville. Under a new accelerated construction plan for the Beltway, right-of-way acquisition began in 2012 and construction started in December 2014. Until construction is completed, travelers wanting to connect between the first and second section of I-74 should stay on US 52 through downtown Winston-Salem, and then take I-40 East to I-74 East towards High Point.[6]

I-73/I-74/US 220, near Asheboro

The second section of I-74 extends from the intersection with I-40 in Southeastern Winston-Salem to High Point. Until January 2019, this section of I-74 was concurrent with US 311. This section was designated despite not having 10-foot shoulders, with the promise that shoulders would be widened later. Signs were installed by August 2014. This section connects directly to another section,[7] called the High Point East Belt. It connects High Point with both I-85 Business and I-85. Construction completed on June 7, 2013 extended the freeway an additional 8 miles to US 220/I-73 at mile marker 86 in Randleman. The highway was originally to be completed by October 2012.[8]

I-74 joins with I-73/US 220 South in Randleman going south to Asheboro. The freeway is already completed, but was not allowed to be signed as a full Interstate until the segment through Asheboro was upgraded to Interstate Highway standards in December 2013. The fourth section of I-74 (and I-73) starts along a bypass of Asheboro where a project to improve US 220 to Interstate standards was completed, and Interstate signs went up in 2012.[7][9]

I-74 continues concurrently with I-73 and US 220 between I-73 mile markers 68-42 (26 miles (42 km)), the first section marked as I-74 (and I-73) in North Carolina in 1997. It continues south bypassing the towns of Seagrove, Biscoe and Candor. Visitor centers (completed in 2010) are located eastbound and westbound at mile marker 61.[10] After Exit 41 U.S. 220 leaves the freeway, the route continues as I-73, I-74 for another 16 miles (26 km) towards Rockingham. Though this part of I-73/I-74 was completed in 2008 and is up to Interstate standards, it was initially signed as a future Interstate route because it had not been accepted into the Interstate Highway System by the FHWA by the time it was opened, necessitating the posting of future shields. This situation was remedied on July 7, 2011 when the FHWA approved the addition of this segment to the Interstate Highway System.[11] The route was finally signed as Interstates 73 and 74 in the fall of 2013.

I-73/I-74/US 220, near Biscoe

At Rockingham, Future I-73 and I-74 will separate from current US 220 along a to-be-built bypass around the west of the city and then join the existing US 74 bypass freeway, which goes south around Rockingham and Hamlet. The first section of the Bypass, four miles of upgraded US 220, is under construction with a planned completion date of March 2018. Future I-73 ends near the NC 38 exit where it is planned to be routed south into South Carolina. Future I-74 continues to the end of the freeway. Between Hamlet and Laurinburg is an at-grade expressway that will eventually be upgraded to Interstate standards. At Laurinburg, I-74 is to use the Laurinburg Bypass was at the standard North Carolina freeway grade and signed as I-74 in 2008; however, NCDOT had to remove the signage the following year when FHWA ruled against using them until the freeway was up to Interstate standards.

The third section of I-74 is officially named the American Indian Highway, completed in 2008, this (19 miles (31 km)) section stretches from Maxton to south of Lumberton, connecting with I-95/US 301.[12] After NC 41, I-74 ends for the final time as the highway continues on as an at-grade expressway signed as US 74/Future I-74 Corridor.

I-74/US 74 near the intersection with I-95 in Lumberton

Future I-74 is to continue to follow US 74, going through the city of Whiteville and bypassing the town of Lake Waccamaw. While there are no funded projects to upgrade the entire highway to Interstate standards, NCDOT is funding several smaller projects to replace intersections with interchanges for several of the remaining cross streets, including for NC 72/NC 130 north of Boardman and replacing other intersections with grade separations, such as with Old US 74 near Evergreen over the next ten years. Before the town of Bolton, it will separate from US 74 onto a proposed new freeway towards Shallotte, then go west on the proposed extension of the Carolina Bays Parkway into South Carolina. This entire section of I-74 is still under a Feasibility Study with several possible routing options, it thus may take years before reaching South Carolina. Current NCDOT plans suggest that construction may not begin until after 2020, and that this will likely be the last section of I-74 to be completed.[13][14]

Though the highway is commonly known as I-74 throughout the state, the highway does have other known names it uses locally in areas.

• American Indian Highway—official name of the 19 miles (31 km) section of I-74 in Robeson County (mile marker 191-213). It is named to honor the large American Indian population in Robeson County.[12]
• Blue Star Memorial Highway—unofficial North Carolina honorary name of I-74 in Randolph County (dedicated on June 7, 2013).[15][16]
• High Point East Belt—road name in Guilford County.

On September 26, 2008, a 19 miles (31 km) section of I-74/US 74 was opened between Maxton to NC 41 near Lumberton, known as the American Indian Highway. The Laurinburg Bypass was also resigned I-74/US 74 at the same time. The following year the Laurinburg Bypass was removed of its I-74 designation by NCDOT, during the Summer, after a ruling from the FHWA (it was re-signed as a Future I-74 Corridor). The reason was that the section, though a freeway by North Carolina standards, it was not up to Interstate standards. It was also at this same time that NCDOT fixed an exit number error along mile markers 181-191.

North Carolina Highway 752 (NC 752) was the designation of the four-lane limited access highway that traversed from I-77 to NC 89, near Pine Ridge. Established in 1994, it was a 1-mile (1.6 km) freeway spur. In 1998, the freeway was extended to US 601 and was renumbered as I-74. Its short four-year existence was simply to be a placeholder for I-74.

The eastern section of the proposed Winston-Salem Northern Beltway is planned to carry I-74 around Winston-Salem, connecting to the existing section of I-74 near High Point. It will carry the designation NC 74 until the eastern section of the road is complete from US 52 to the existing section of I-74, at which point the designation will be replaced with I-74.[34]

The first segment to go to construction, connecting US 158 and US 421 (Salem Parkway), began in December 2014[6][35] and was scheduled to open in fall of 2019.[34] The next segment, from US 311 to US 158, began construction in 2018. A contract for the section between NC 66 and US 311 was awarded the same year,[36] with construction beginning in 2019. The remaining section between US 421 and the existing I-74 is scheduled to begin construction in 2020[6][36] and to open in 2024.[34]

A western bypass of Rockingham is planned, beginning at the partially-built trumpet interchange with US 220 where I-73 and I-74 currently end, and running southwest to the trumpet interchange between US 74 and US 74 Business, which will be reconfigured to accommodate the new bypass. Construction was initially scheduled for 2026, but was rescheduled for late 2019, and is planned to last three years, costing $146.1 million.[37][38] Upon completion of the bypass, I-74 will be designated along its length and along US 74 around Rockingham and Hamlet, terminating east of Hamlet at US 74 Business.[39] The bypass will also carry I-73, which will terminate at the interchange with US 74 west of Rockingham until the section of I-73 extending into South Carolina is completed.[39]