It runs from the Virginia state line near Bluefield, where it is concurrent with Interstate 77 (I-77), in a general northwest and north direction to I-64 at Kenova.

The West Virginia segment is signed such that US 52 north corresponds to the general westward direction of the highway, and vice versa.

In late 2002, Senator Robert C. Byrd received $20 million in funds to jump-start construction on the northern half of the Tolsia Highway.

The money would be used to speed up construction on the 10-mile (16 km) link between Huntington and Prichard, serving several industrial parks and relieving two-lane US 52 of coal-truck congestion.

Interchanges and intersections proposed for the King Coal Highway include:[1] Note that this is WVDOT’s preferred route and is subject to change.

Construction began in 1999 on the three-level diamond interchange on Indian Ridge near Welch that will facilitate traffic between the King Coal Highway (US 52, Interstate 73/74) and the Coalfields Expressway (US 121).

On November 24, a contract totaling $2,057,914 was let to move approximately 500,000 cubic yards (380,000 m3) of dirt and to grade and drain .22 miles from the recently completed $27 million interchange with Corridor Q (US 460) east of Bluefield to US 19 just north of James P. Bailey Lake.

This is the first of several projects that will extend the King Coal Highway to West Virginia Route 123 (Airport Road) north of Bluefield.

The contract calls for more than 200,000 cubic yards (150,000 m3) of excavation to grade and drain .18 mile of the King Coal Highway from county route 25 just north of the US 460 interchange to south of the old Raleigh-Grayson Turnpike.

[4][5] Design work is being commenced on a 11-mile (18 km) segment of the King Coal Highway from Horsepen Mountain to Isaban and from the Mercer County Interchange to West Virginia Route 123/Airport Road.

The work being done on a 2.5-mile (4.0 km) section of highway near Horsepen Mountain is being done by mining companies that will save taxpayers over $20 million.

Both authorities were later shut down and local officials have been pushing for state lawmakers to reprioritize the construction of the King Coal Highway ever since.

[6] In June 2023, the West Virginia Department of Transportation (WVDOT) announced that bids were let for the construction of the highway near Gilbert.