The 1st US 220 Business was created in 1961 as a renumbering of US 220 through Madison and Mayodan.
About 1965, US 220 Business was extended north through Stoneville. No official state highway map ever showed it and today but NCDOT county maps show US 220 Business extended north through Stoneville back to US 220 at Price up through at least 1980.
In October 1997 (NCDOT), US 220 Business was truncated to south of Stoneville, leaving behind SR 1603.

US 220 through Madison/Mayodan 1960 Official

US 220 Business through Madison/Mayodan 1961 Official

US 220 Business through Stoneville too 1968 Rockingham County

The 2nd US 220 Business was created in 1966 as a renumbering of US 220 through Ulah and Asheboro.
In Nov 1972 (NCDOT), the US 220 bypass of Asheboro was extended north to US 311. US 220 then replaced US 311 east back to the original route. The NCDOT approval document stated that US 220 Business cut west to US 220 at Balfour along what had been the original north end of 220 Bypass.
In 1974, US 220 bypassed Randleman and US 220 Business was put back onto original US 220 through Randleman to Level Cross, then west on what had been the interim US 220 Bypass over to US 220 freeway.

US 220 Business through Ulah and Asheboro 1968 Official

US 220 Business cuts west to US 220 1973-74 Official

US 220 Business extends through Randleman and Level Cross 1974-75 Official

There is 1 US 220 Business segment that no longer exists:
The 3rd US 220 Business was created in 2008 as a renumbering of US 220 through Ellerbe, Norman, and Emery.
In early 2014, US 220 Business was restored to being mainline US 220.

US 220 through Ellerbe 1997-98 Official

US 220 Business through Ellerbe, Norman, and Emery 2008-09 Official