U-turn lanes are commonly provided at at-grade diamond interchanges with frontage roads to reduce delays for U-turning traffic and for the interchange as a whole; however, there are currently many unknowns related to their design, operation, and use. Researchers of this study assessed the existing practice of U-turn implementation by evaluating operations of U-turn lanes at 25 diamond interchanges in Texas through field data collection and simulation analysis. Researchers determined the performance and limitations of U-turn lanes under various geometric and operational conditions, identified and investigated several factors affecting U-turn lane use, and determined the anticipated effectiveness of proposed solutions to U-turn operational issues. This paper provides implementable guidelines for designing and operating U-turn lanes at diamond interchanges. Among the ten countermeasures studied in this paper, closing nearby driveways, adding acceleration lane for U-turn departures, and separating U-turn departures from conflicting traffic using pylons were found to be effective solutions to improve U-turn operations.