The route exits the state into Virginia, running concurrently with Interstate 64 (I-64) east of White Sulphur Springs.

The Midland Trail is a National Scenic Byway which follows US 60 through a portion of the Southern West Virginia between Charleston and Sam Black Church.

The trail extends for approximately 100 miles (160 km) from White Sulphur Springs in the east to Charleston in the west.

[citation needed] Prior to 1988, the Midland Trail was heavily traveled, particularly by commercial vehicles, including large trucks transporting coal and timber.

[citation needed] Although considerably shorter than the Interstate Highway routing via the West Virginia Turnpike, these days, the Midland Trail serves mostly local traffic and shunpikers seeking a bucolic interlude.