U.S. Route 52 skirts the western fringes of the U.S. state of West Virginia. It runs from the Virginia state line near Bluefield, where it is concurrent with Interstate 77, in a general northwest and north direction to Interstate 64 at Kenova. There it turns east, overlapping Interstate 64 for five miles (8 km) before splitting off onto the West Huntington Expressway into Ohio via the West Huntington Bridge. Despite having an even number, US 52 is signed north–south in West Virginia.

Most of the route is being upgraded to a high-speed four-lane divided highway, but not to interstate standards. It has been designated as part of the Interstate 73 and Interstate 74 corridors. From Interstate 77 south of Bluefield to near Williamson, the new highway has been referenced to as the King Coal Highway; from Williamson north to Kenova, it is the Tolsia Highway.

The West Huntington Expressway is a controlled access elevated highway that crosses the west end of Huntington WV. It was constructed in 1965 and originally signed as West Virginia Route 94. The first segment to open was a stub from Interstate 64 to Jefferson Avenue in West Huntington in the fall of 1965. This included a bridge over a CSX railroad mainline. In the early 1970s, the expressway was extended northward across what is now the Nick Joe Rahall II Bridge across the Ohio River to U.S. Highway 52/State Route 7 in Ohio.

Tolls were collected at the Ohio River bridge until the mid-1980s. The expressway has four lanes from Interstate 64 to the U.S. Highway 60 interchange, where it drops to two lanes for the remainder of the highway, which includes the Ohio River bridge. The expressway was renumbered U.S. Route 52 in 1979 when that federal highway was re-routed out of downtown Huntington to a new alignment on I-64 west to the Tolsia Highway south of Kenova.

The Tolsia Highway is defined as running from Interstate 64 at Kenova to Corridor G (US 119) north of Williamson. Portions of the 66-mile (106 km) highway have been completed. In 1998, US 52 south of the Interstate 64 interchange in Kenova was upgraded to four-lane highway standards to the Tri-State Airport Access Road. In 2001, the four-lane highway was extended southward approximately two miles to a stub interchange with West Virginia Route 75, removing a steep downgrade with a large sweeping curve.

Also in 1998, the Prichard, West Virginia bypass was opened to traffic with one interchange and one at-grade intersection. This four-mile (6 km) bypass includes very large rock cuts and a long and winding grade down a hill. In 2001, the four-lane highway was extended northward for one mile (1.6 km), removing some grades and curves along US 52. The extension was completed in 2002 at a cost of $9,613,889.26. New signage was installed in late 2002 to replace orange construction signs that date to the construction of the bypass.

Before the eastern bypass was built, US 52 inside Prichard involved two alignments. U.S. 52 originally took the path of West Virginia Route 152, approximately 10 miles (16 km) east of the current alignment. In the mid-1960s, state funding was secured to upgrade most of county route 1, which ran along the Big Sandy River and Tug Fork River. The upgraded county route 1 was renumbered as US 52 in 1979. A western bypass of Prichard was constructed in the mid-1970s and partially abandoned in 1999, when the new four-lane alignment east of the community was constructed.

In 2001, the Crum segment of the Tolsia Highway opened to traffic. The highway begins just north of Crum, touching down at an incomplete diamond interchange with US 52 and heads eastward towards county route 2. It has at-grade intersections with county route 52-47 and county route 52-31 along with a side road at the eastern terminus that takes traffic to county route 2. There are stubs for future bridges and ramps. Signage along this segment is minimal, with only a handful of arrows to designate the route. While the highway was built to four-lane standards, it is only striped for two.

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

In 2003, survey and design of five miles (8 km) of four-lane US 52 upgrades from Prichard north to Cyrus were completed. This includes an interchange and five bridge structures. Estimated cost of construction is $90 million.

Total design work for 2003-2004 on the Tolsia Highway totals over 18 miles (29 km).

The unfunded six-year transportation plans, released by the West Virginia Department of Transportation in 2005, has listed the Tolsia Highway as under several contracts. The six-year priority plans also list several Tolsia Highway projects with funding estimates and details.

U.S. 52 enters Kentucky twice along the Williamson, West Virginia bypass, preventing the blasting of several hillsides in West Virginia. It was completed in 1996 as part of the Corridor G (U.S. Route 119) project. The speed limit in West Virginia is 65 mph (105 km/h) but abruptly drops to 55 mph (89 km/h) in Kentucky.

The Tolsia Highway is expected to meet the King Coal Highway at West Virginia Route 65 and Corridor G (US 119).

The Delbarton Connector is part of the King Coal Highway, and will act as a four-lane expressway connecting US 119/US 52/Corridor G north of Williamson to the King Coal at Delbarton. Right-of-way acquision will commence in 2007, with construction beginning in 2008. It is also referred to as the Williamson Connector.

The King Coal Highway is defined to run from West Virginia Route 65 and Corridor G (US 119) near Belo, West Virginia to Interstate 77 at its US 52 interchange near Bluefield. Interstate 66, Coalfields Expressway (US 121) and the Shawnee Expressway will connect to the King Coal Highway.

The travel time, currently over 120 minutes from Williamson to Bluefield, will be reduced to 87 minutes. South of Ikes Fork, a two-hour trip to Bluefield will be reduced to 44 minutes.

Interchanges and intersections proposed for the King Coal Highway include:

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).[citation needed] Initial site work was completed in 2003, with grading evident; this required the filling in of a large valley. It will also be the site of a new state prison along with future industrial development.

Work has progressed on the four-lane upgrading of US 52 in Mercer County just east of Bluefield. On November 24, a contract totalling $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. Six buildings will be demolished. This is the first of several projects that will extend the King Coal Highway to West Virginia Route 123 (Airport Road) north of Bluefield. Extending this project east, another contract was awarded December 15 and totals $1,371,251. 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. 36 buildings will be demolished. A future contract will include a bridge over US 19 which will cost $15 million.

Work is set to begin on a 1.37-mile (2.20 km) stretch of roadway in Raleigh county at a cost of $12.2 million. This includes paving, guardrail installation, pavement marking, and signing operations for this segment.

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.

The total cost for both the Tolsia and King Coal Highways will be over $2 billion.