The highway connects Richmond with Tappahannock on the Middle Peninsula and the eastern Northern Neck, where it serves as the primary route through Northumberland County.

US 360 heads east along four-lane divided River Street with US 58 Business, and passes under Norfolk Southern Railway's Danville District rail line.

[1][2] US 360 briefly runs atop the Prince Edward – Lunenburg county line before fully entering Prince Edward County, where the highway parallels the Virginia Southern Railroad to the south and Norfolk Southern Railway's Blue Ridge District to the north.

It passes around the community of Bruceville and through the town of Meherrin, where the highway crosses to the north side of the Blue Ridge rail line.

It parallels both rail lines to Burkeville, in the southwestern corner of Nottoway County, where the road's name changes to Patrick Henry Highway.

US 360 and US 460 bypass the town to the north and receive the eastern end of their respective business routes before diverging at a partial interchange.

West of Jetersville, the highway intersects the eastern end of SR 307 (Holly Farms Road), which connects to US 460 northwest of Burkeville.

[1][2] US 360 continues northeast as a six-lane highway through additional suburban areas before its partial-cloverleaf interchange with SR 150 (Chippenham Parkway), where the it enters the city of Richmond and reduces to four lanes.

The U.S. Highway crosses CSX's North End Subdivision and becomes Hull Street at its intersection with SR 161 (Belt Boulevard).

The two highways pass under I-95 (Richmond–Petersburg Turnpike) and CSX's Bellwood Subdivision and by the Main Street Station serving Amtrak's Northeast Regional trains during their four-block concurrency.

US 360 turns north onto four-lane undivided Mechanicsville Turnpike and has a partial-cloverleaf interchange with I-64 before exiting the city of Richmond as a six-lane divided highway.

US 360 passes through the Henrico County community of East Highland Park, where it intersects Laburnum Avenue, which leads to Richmond Raceway.

The highway crosses the Chickahominy River into Hanover County, where it reduces to four lanes at the southern end of Mechanicsville's US 360 Business.

The movement from westbound US 360 to SR 156 is provided at the northern end of the bypass, which occurs a short distance south of US 360's cloverleaf interchange with I‑295.

At Aylett, the site of Zoar State Forest, US 360 crosses the Mattaponi River into King and Queen County, where it meets the western end of SR 14 at the community of St. Stephens Church.

US 360 expands to a divided highway at the hamlet of Indian Field and passes through Haynesville before entering Northumberland County at Village.

The highway veers northeast at Luttrellville and meets the eastern end of SR 202 (Hampton Hall Road) in Callao.

US 360 has another divided-highway section before reducing to two lanes through Heathsville, where it passes St. Stephen's Episcopal Church and intersects SR 201 (Courthouse Road).

The business routes pass through the town as 2nd Street before rejoining US 360 and US 460 a short distance west of their eastern divergence point.

US 360 Business is called Goodes Bridge Road and runs parallel to Norfolk Southern Railway's Richmond District along the northwest side of the village center, where the highway meets the western end of SR 38 (Virginia Street).