US 460 from Interstate 81 at Christiansburg west to Pikeville, Kentucky, including the piece in West Virginia, is Corridor Q of the Appalachian Development Highway System.
From West Virginia east to I-81, US 460 also is part of the proposed Interstate 73. Highway heads southeast as a two-lane road parallel to Norfolk Southern Railway's Buchanan Branch in the narrow valley of the Levisa Fork of the Big Sandy River.
US 460 descends Sandy Ridge south along Coal Creek and passes through the community of Red Ash. Peery, curves east and begins to parallel Norfolk Southern's Clinch Valley District rail line and the Clinch River at Raven, where the highway is paralleled by and is joined by SR 67. Highway continues into the town of Cedar Bluff and has a pair of right-in/right-out interchanges with its business route, here named Cedar Valley Drive.
US 460 and SR 67 enter the town of Richlands; west of the downtown area, US 460 Bus. US 460 passes to the north of downtown and has a partial cloverleaf interchange with SR 67 (Railroad Avenue). US 460 leaves the railroad and river, collects the eastern end of its business route, and heads south out of Cedar Bluff to Claypool Hill, where the highway intersects US 19 (Steelburg Highway).
Within the Park is the 167-acre Lake Maury, which is encircled by the five-mile Noland Trail.Construction started in the spring of 2015 on a new diverging-diamond interchange that replaced the at-grade Southgate Drive intersection.The new interchange is just south (east) of the current intersection and serves both the Virginia Tech campus and the Corporate Research Center via new roads and a relocated Southgate Drive (including two roundabouts).The mainline highways have a partial cloverleaf interchange with SR 16 Alt.(Fairground Road) at the western town limit of Tazewell. Highways have a pair of right-in/right-out interchanges with SR 645 and SR 678, cross the rail line, and have a partial interchange with the eastern ends of their business routes. Highways follow the river through Springville to the town of Bluefield, at the west end of which US 19 (Trail of the Lonesome Pine) splits northeast at a trumpet interchange to pass through the centers of the twin cities of Bluefield, Virginia, and Bluefield.US 460 and US 19 continue through a diamond interchange with SR 16 (Tazewell Avenue) and a partial cloverleaf interchange with SR 61 (Riverside Drive) at a crossing of the Clinch River and the railroad west of downtown Tazewell. US 460 and US 19 continue east between East River Mountain to the south and Little Valley Ridge to the north; the highways leave the Tennessee River watershed and enter the valley of the Bluestone River, which is part of the New River watershed. On the southern edge of the town, US 460 parallels SR 720 (Fincastle Turnpike and Valley Dale Street) and has a pair of partial cloverleaf interchanges with that highway; the eastern interchange leads to SR 102 (College Avenue). Highway serves that state's Bluefield and Princeton before re-entering Virginia near where the New River crosses the Virginia–West Virginia state line. Highway, named Virginia Avenue throughout Giles County, crosses the East River, briefly parallels a bend in Norfolk Southern Railway's Christiansburg District, and crosses to the east side of the New River.