The junction is also adjacent to the crossing of Norfolk Southern Railway's Altavista and Danville district rail lines.

SR 43 heads northwest as Bedford Avenue to the town limit at the highway's diamond interchange with US 29 (Wards Road).

[2][7] SR 43 exits the town of Bedford on Peaks Road, which crosses the Otter River on its way to Blue Ridge Mountain.

The southern section of SR 43 reaches its northern terminus at the Blue Ridge Parkway adjacent to the Peaks of Otter Visitor Center.

[2][7] The Blue Ridge Parkway heads northwest to Bearwallow Gap, where the northern section of SR 43 begins at an interchange.

The state highway, which is named Parkway Drive, enters Botetourt County and descends Cove Mountain to the town of Buchanan.

On the north side of the river, the state highway turns west onto First Street and leaves the town as Narrow Passage Road, which re-enters the national forest.

The state highway follows the river north a short distance to its northern terminus at US 220 (Botetourt Road).