Six special routes of U.S. Route 169 exist, one each in Oklahoma, Kansas, Missouri, and Iowa, and two in Minnesota.

Nowata alternate route

U.S. Highway 169 Alternate (US 169 Alt.) at Nowata is the only special route for US 169 in Oklahoma. The alternate route travels through Nowata while the main highway bypasses the town. The alternate route is approximately 2.70 miles (4.35 km) long.^[1]

The entire route is in Nowata, Nowata County.

mi	km	Destinations	Notes
		US 169
		US 60
		US 169
1.000 mi = 1.609 km; 1.000 km = 0.621 mi

Garnett business route

U.S. Highway 169 Business (US-169 Bus.) in Garnett is the only special route of US-169 in Kansas. The business route northern terminus is the junction of US-169 and 6th Avenue in Garnett. The main highway bypasses the town to the southeast. The business route travels along 6th Avenue until Maple Street, where it intersects US-59 and K-31 until it ends at its intersection with US-169 at a roundabout south of Garnett in Anderson County.

Smithville spur

U.S. Route 169 Spur is a 1⁄2-mile-long (800 m) route in Smithville, Missouri. The spur route follows an old alignment of US 169 into the city center of Smithville, ending at Main Street.

The entire route is in Smithville, Clay County.

mi[3]	km	Destinations	Notes
0.000	0.000	US 169
0.298	0.480	Route F
0.536	0.863	Route DD (Main Street)
1.000 mi = 1.609 km; 1.000 km = 0.621 mi

Fort Dodge business loop

U.S. Route 169 Business (US 169 Bus.) is a 3.1-mile-long (5.0 km) business route in Fort Dodge, Iowa. The route was established in 1990 along former sections of Iowa Highway 7 (Iowa 7) and US 20. Iowa 7 had recently been truncated to its current eastern end at US 169, and US 20 had been rerouted onto a new freeway south of Fort Dodge. Since both routes had viaducts over the Des Moines River, officials in Fort Dodge wanted the Iowa Department of Transportation to maintain the bridges.^[5] From its creation until 2014, the route was officially known as Iowa  926, but it was only signed as US 169 Bus.^[6] The entire route is in Fort Dodge, Webster County.

mi[4]	km	Destinations	Notes
0.000	0.000	US 169 (Lainson Avenue) / US 20 Bus. west	Southern end of US 20 Bus. concurrency
1.625	2.615	US 20 Bus. east (Kenyon Road)	Northern end of US 20 Bus. concurrency
3.147	5.065	US 169 (Lainson Avenue)
1.000 mi = 1.609 km; 1.000 km = 0.621 mi       Concurrency terminus

Shakopee business route

U.S. Highway 169 Business is a business route in Shakopee, Minnesota.

Hibbing business route

U.S. Highway 169 Business is a business route in Hibbing, Minnesota.