The course follows The Old Ghost Road in a north to south direction (starting at the Seddonville end of the trail and finishing at Lyell).

The course is 85km long and involves 2,600 metres of ascent.  The starting elevation is 30 metres above sea level (Seddonville) and the finishing elevation is 100 metres above sea level (Lyell).  The maximum elevation attained is 1,340 metres above sea level near 'Heaven's Door' on the mighty Lyell Range.  Almost 15km of trail is over 1,000 metres elevation.

Competitors are advised to not only note the course length and wilderness setting, but the elevation profile (refer maps below).  The majority of the elevation gain occurs in the second half of the course after competitors have already run the equivalent of a marathon. The Old Ghost Ultra is not for the faint-hearted and should not be taken lightly.