The short Interstate 381 constitutes a freeway spur from Interstate 81 into downtown Bristol, Virginia. The only interchange of the route is the northern terminal with Interstate 81/U.S. 58. Otherwise the spur transitions to unsigned Virginia 381 en route to U.S. 11/19/421 to the south.
All signage for the Virginia 381 continuation southward to Bristol, Tennessee was removed by 2005. The set of flashers with Keys Street at the freeway south end was upgraded to a traffic light by 2007. Widening of Interstate 81 at the north end was completed by 1998.