An additional condition was set that each city must hold a referendum on the question of whether to allow casino gaming in the city. In 2020, the Virginia legislators passed a bill allowing the establishment of casinos, but limited to five eligible host cities of Portsmouth, Richmond, Norfolk, Danville, and Bristol.
On July 8, 2022, the temporary Bristol Casino had a soft open at the site. Located at the former Bristol Mall, which operated from 1975–2017, the casino will utilize the existing facility and expand upon it with a hotel and outdoor amphitheater. Hard Rock Hotel & Casino Bristol is a future casino and hotel in Bristol, Virginia, slated to be officially open in 2024.