Special routes of U.S. Route 220
Several special routes of U.S. Route 220 exist. In order from south to north they are as follows.
North Carolina
Candor–Seagrove alternate route
U.S. Route 220 Alternate, established in 1979, is an route that follows the old US 220 route through Candor, Biscoe and Star. In 1997, it was extended further north through Seagrove to its current terminus near Ulah. In 2008, the US 220 Alt was temporary extended south to NC 73, while mainline US 220 was on new freeway filling in for Future I-73/I-74; In 2013, mainline US 220 was moved back on that section. Predominantly a two-lane rural highway, it begins at exit 41 interchange from I-73/I-74/US 220 and ends at US 220 Bus, just from exit 68.;Major intersections
Asheboro business loop
U.S. Route 220 Business was established in 1966 when mainline US 220 was rerouted onto new freeway bypass from south of Ulah to Vision Drive, in Asheboro. In 1972, US 220 Bus replaced some of the mainline along Vision Drive as new freeway was built further north towards US 311. In 1974, US 220 Bus was removed from Vision Drive and continued north along the old mainline route, through Randleman, to Level Cross. In 1982, US 220 Bus was adjusted at Level Cross, replacing some of the mainline to its current terminus with US 220 interchange. US 220 Bus is two-lane along its routing outside Asheboro and three to four-lane in Asheboro.;Major intersections
Virginia
Ridgeway business loop
U.S. Route 220 Business in Ridgeway, Henry County follows the old route of US 220 through downtown Ridgeway along Church Street and Main Street.Martinsville business loop
U.S. Route 220 Business departs US 220 at the junction with US 58 south of Martinsville in Henry County. It heads north as Greensboro Road, following US 220's old alignment. North of its junction with US 58 Bus in Martinsville, it crosses the Smith River and becomes known as Memorial Boulevard, a name it retains even after separating from US 58 Bus and joining SR 57 at Starling Avenue. SR 57 separates from US 220 Bus at Fayette Street, with US 220 Bus continuing on Memorial Boulevard. After re-entering Henry County, US 220 Bus intersects Commonwealth Boulevard and changes its name to Virginia Avenue. It retains this name through Collinsville before rejoining mainline US 220. West of US 220, Virginia Avenue becomes known as Fairystone Park Highway, a portion of SR 57.Rocky Mount business loop
U.S. Route 220 Business begins at an interchange two miles south of Rocky Mount as South Main Street. The street continues north through residential neighborhoods as it passes Franklin Memorial Hospital and the Franklin County Courthouse in downtown Rocky Mount. The route continues north as Main Street and intersects with Virginia State Route 40. The street becomes North Main Street as it continues north through town. North Main St intersects with State Route 919 just before the final interchange with US 220.Roanoke business loop
U.S. Route 220 Business begins at an interchange with US 220 in the southwest corner of Roanoke. From there, it runs north along Franklin Road to Williamson Road, then north along Williamson Road to Orange Avenue where it terminates at US 220 Alternate.Roanoke alternate route
U.S. Route 220 Alternate is a route that appeared in 1979 as a concurrency with US 460/US 221 from the junction of I-581/US 220 in downtown Roanoke and then north on the route of former secondary State Route 604 from Bonsack in Roanoke County to just north of Cloverdale in Botetourt County. There, its terminus is at an interchange of I-81, US 220 and US 11.In the 1930s and 40s, the Bonsack to Cloverdale route was part of VA 114 until it was downgraded to SR 604 in April 1944. In the 1990s, the section from Bonsack to Cloverdale was widened to four lanes and it serves as a bypass for US 460 seeking to avoid Roanoke traffic congestion.
Previously, the Rocky Mount bypass was designated as US 220 Alternate from its construction in 1960-61 until it was changed to US 220 Bypass between 1968 and 1970.