West Virginia Route 161 is an east–west state highway located entirely within McDowell County, West Virginia. The western terminus of the route is at West Virginia Route 16 in Bishop less than 900 feet (270 m) from the Virginia state line. The eastern terminus is at U.S. Route 52 in Elkhorn. At Bishop, WV 161 enters Virginia for approximately 500 feet (150 m). The state line follows Jacobs Fork and Horsepen Creek, which form a tight bend.