The Median U-turn design greatly simplifies major intersection signal operations:

Direct left turn movements are prohibited at the major intersections, therefore creating a simple two-phase signal control.

Left turn movements are made indirectly using directional left-turn crossovers immediately up and downstream of the crossroad intersection.

The Median U-turn design requires a wider median in which to make efficient u-turn movements for both autos and trucks. AASHTO provides guidance on median requirements based on number of lanes and design vehicles.

Deciding the appropriate distance from a major crossroad intersection to the first U-turn crossover opportunity is a trade-off between providing a sufficient U-turn storage bay length (to minimize spillback potential) and keeping the left-turning path length short (to minimize travel time).

Signing is particularly important for safe and efficient operations of the Median U-turn design. The most common and widely accepted signing is the "fishhook" design, used at the main intersections and at major crossover locations. Other regulatory signing requirements are similar to any conventional median highway.