The route began at a diamond interchange shared by the eastern terminus of KY 1384 and ran east where it eventually curved south and west around into downtown Pikeville.

The road begins as Front Street at an at-grade interchange with US 460 west of downtown Richlands, taking a concurrency with State Route 67 away from that route and immediately crosses a bridge over the Clinch River while running parallel to a Norfolk and Western Railroad line.

The railroad tracks move away from Front Street west of the SR 609 (Veterans Drive) bridge.

Near Richlands High School, the road turns southeast once again, descending gradually down a hill as it approaches its parent route.

US BUS 460 ends at an unconventional quarter-cloverleaf interchange with US 460 at the Richland-Cedar Bluff border, which is also shared with the western terminus of SR 631 (Cedar Valley Drive).

[1] The route begins at an at-grade intersection near the Historic Crab Orchard Museum, running southeast.

West Fincastle Turnpike, which ran parallel to the north side of the road since SR ALT 16 merges with US BUS 19/460/SR 16 at the beginning of an undetermined historic district.

Later the turnpike passes the Tazewell High School and some gas stations mixed in with primarily a residential area, which becomes more commercial east of Perry Street.

Only after this intersection does the road run parallel to the North Fork of the Clinch River and a former Norfolk and Western Railroad line.

At the corner of the Giles County Courthouse, the route turns left onto Wenonah Avenue, and the concurrency with SR 100 ends.

The route travels east out of downtown, then reaches US 460 at a standard off-ramp after passing the Giles High School.

After US 460 curves to the south, US BUS 460 branches off to the southeast between Bishop Road (SR 648) and Farmingdale Lane, and is named North Main Street.

Eventually it curves straight south as it passes by the runway of the Virginia Tech Montgomery Executive Airport.

After the intersection of SRs 808/643, the route passes by the Lewis-Gale Hospital-Montgomery, which is flanked to the south and west by SR 775.

From there the road climbs a hill, then descends as it passes a historical marker for the Christiansburg Industrial Institute next to an Appalachian Power substation before crossing the bridge over Crab Creek, which also runs over a two-tracked Norfolk and Western Railway line that pass by the nearby Cambria Freight Station.

US BUS 460/SR 163 runs in a northeast concurrency as a four-lane undivided highway until it reaches the Fort Early and Jubal Early Monument, where SR 163 diverges north as two-lane Memorial Avenue at an acute intersection, and US BUS 460 becomes a two-lane highway as well.

US 221/BUS 460 runs along the northwest side of the Spring Hill Cemetery and after they veer onto 12th Street the routes are joined by US BUS 501 at Campbell Avenue.

After the bridge over the Norfolk Southern Railway's Danville District rail line all three routes turn south onto Kemper Street, which becomes a four-lane divided highway past 16th Street as it approaches the interchange with US BUS 29, an interchange that stands as the northern terminus of US 221.

Kemper Street runs beneath another railroad line then veers back towards Campbell Avenue and ends there, but US BUS 460/501 continue south onto Campbell Avenue, as does the status as a four-lane divided highway until the divider ends just before it crosses a bridge over Norfolk Southern Railway's Blue Ridge District.

The concurrency with SR 24 ends shortly after this interchange and makes a left turn onto Old Courthouse Road as it heads for Mt.

The route ends at a wye interchange at US 460 that includes a single east to west ramp between eastbound US 460 and westbound US BUS 460.

It begins at a trumpet interchange with the west end of a concurrency with US 15 and briefly runs north before making a sharp right turn onto U.S. Business Route 15 and SR 695.

The formerly overlapped secondary route intersects again, and later terminates at US BUS 15/460 just north of the High Bridge Trail.

After crossing the bridge over Brirey Creek, US BUS 460 finally ends at a wye interchange with US 460 southeast of the town.

The route begins at an unusual half-diamond/trumpet interchange onto a street called "Old Nottoway Road" which immediately runs over a bridge over a Norfolk and Western Railroad line southeast of the eastbound on-and-off-ramps of US 460.

The rest of the route runs mostly southeast and is almost entirely rural with barren forests interrupted occasionally by farmland, moderate to minor intersections, and abandoned local businesses.

US 1/BUS 460 makes a sharp turn to the east around Central State Hospital and becomes West Washington Street.

It begins at the partial cloverleaf interchange and the west end of US 460's concurrencies with US 13 and US 58, running southeast where it crosses over a bridge near Sadler Pond, and then curves to the south as it merges with State Route 10 and State Route 32 running in a short concurrency.

After crossing a railroad line it shifts onto an interchange with Interstate 264 at Exit 4 and heads east through a fly-under ramp.

The road shares a concurrency with I-264 through the Downtown Tunnel, and then the Berkley Bridge until it leaves at eastbound Exit 10 onto SR 337 again, this time along Tidewater Drive.