Seven special routes of U.S. Route 278 currently exist. Three of them lie within the state of Arkansas. One more existed in the past but has since been decommissioned.
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Hope business route
U.S. Route 278B (US 278B and Hwy. 278B) is a 1.15-mile (1.85 km) business route of U.S. Route 278 in Hempstead County, Arkansas.
The route's northern terminus is at US 278 near Interstate 30 along the outside of Hope. The route runs south as Hervey Street through downtown Hope past the Foster House and the Bill Clinton Birthplace both two properties being National Register of Historic Places (NRHP) listed. The route terminates at US 67.
The entire route is in Hope, Hempstead County.
Camden business route
U.S. Route 278B (US 278B and Hwy. 278B), formerly Highway 4B, is a 2.97-mile (4.78 km) business route of U.S. Route 278 (formerly Highway 4) in Ouachita County, Arkansas.
The entire route is in Camden, Ouachita County.
Warren business route
U.S. Route 278B (US 278B and Hwy. 278B), formerly Highway 4B, is a 3.99-mile (6.42 km) business route of U.S. Route 278 (formerly Highway 4) in Bradley County, Arkansas.
The entire route is in Warren, Bradley County.
Rockmart business route
U.S. Route 278 Business (US 278 Bus.) is a 3.2-mile-long (5.1 km) business route of US 278. Nearly the entire road is within the city limits of Rockmart. Its entire length is concurrent with State Route 6 Business (SR 6 Bus.).
The business route begins at an intersection with US 278 / SR 6 west of Rockmart. It travels to the southeast and is known as Cedartown Highway until an intersection with Prospect Road. Then it is known as Elm Street. It enters the city limits of Rockmart and passes by Rose Hill Cemetery. Then, it crosses over Euharlee Creek and the Silver Comet Trail on the Raymond Lester Bridge. The highway then curves to the east, at an intersection with Slate Street. At Piedmont Avenue, the business route turns to the north, remaining along that street for the rest of its journey. At an intersection with Clearwater Street, it curves to the north-northwest. Finally, it ends an intersection with US 278 / SR 6 / SR 101.
The entire route is in Polk County.
Madison Truck Route
U.S. Route 278 Truck (US 278 Truck) is a southern truck route of downtown Madison. The entire length is also in concurrency with SR 12 Truck (SR 12 Trk.), but is also in concurrency with Spur Route 24, US 129/441/SR 24, and US 129/441 Bypass/Bypass Route 24.
The bypass route begins at mainline US 278 / SR 12, which turns northeast at a fork in the road as those routes head into historic downtown Madison. The truck route runs along a concurrency with State Route 24 Spur (Ward Road), curving southeast until it reaches U.S. Route 129 in Georgia/U.S. Route 441 in Georgia/Georgia State Route 24, and turns south onto a concurrency with these routes after the spur route ends. The route continues until it reaches the southern terminus of the U.S. Route 129/441/SR 24 Bypasses and follows that route entirely as well. US Truck Route 278 /SR Truck Route 12 ends at US 278 / SR 12 as well as the northern terminus of the overlap with US 129/441/SR 24.
The entire route is in Morgan County.
Warrenton bypass
U.S. Route 278 Bypass (US 278 Byp.) was established in 1989 as a southern bypass of downtown Warrenton. The entire length is also in concurrency with SR 12 Bypass (SR 12 Byp.). Banner signage along route mostly use "Truck" instead of "Bypass."
The bypass route begins at mainline US 278 / SR 12, which turns from southeast to straight east as those routes head into historic downtown Warrenton. At first, it crosses a former Central of Georgia Railway line before encountering the intersection with State Route 16. After the intersection of Shoal Street, the route begins to curve east in front of the right-of-way of a former connecting ramp to SR 16. The road serves as the northern terminus of State Route 171 across from the Warren School Bus Shop, and then starts moving northeast, even moreso when it approaches State Route 80 (Quaker Road) which joins the bypass in a concurrency. US Truck Bypass 278 /SR Truck Bypass 12 ends at US 278 / SR 12, but SR 80 continues north towards Waynesboro and Shell Bluff.
Hilton Head business route
U.S. Route 278 Business (US 278 Bus) was established in 1998 when the Cross Island Parkway was completed and US 278 was rerouted onto it. US 278 Bus travels along William Hilton Parkway, which connects to the Hilton Head Airport and various resorts on the island.