 Middlecreek Township is bordered by Jefferson Township to the northeast, Milford Township to the east, Upper Turkeyfoot Township to the south, and Fayette County to the west.Both Pennsylvania Route 281 and Pennsylvania Route 653 pass through Middlecreek Township, forming a concurrency for the section between New Lexington and New Centerville.The borough of Seven Springs is located at the northern tip of Middlecreek Township, spilling over into Fayette County.