U.S. Route 220 Alternate is a 11 miles route that appeared in 1979 as a concurrency with US 460/US 221 from the junction of I-581/US 220 (Exit 7) 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.