The byway begins in Keysers Ridge and follows I-68 west to Friendsville, where Youghiogheny River Lake is located. At this point, the byway continues south along MD 42 toward US 219. The Mountain Maryland Scenic Byway followed US 219 to McHenry, which is home to Wisp Ski Resort and Deep Creek Lake State Park. The byway heads west on Mayhew Inn Road and Swallow Falls Road, coming to Swallow Falls State Park. A spur on Cranesville Road provides access to Cranesville Swamp Preserve. The Mountain Maryland Scenic Byway continues south along Herrington Manor Road and comes to Herrington Manor State Park before heading to the historic town of Oakland. From Oakland, the byway follows MD 135 through Mountain Lake Park and Deer Park, coming to the Potomac-Garrett State Forest. A detour in the state forest follows MD 560. There are also diversions along MD 495 to rural areas of the Allegany Highlands, MD 38 to Kitzmiller, and Savage River Road to the Savage River State Forest. The mainline of the byway continues to descend Backbone Mountain on MD 135 before heading along MD 36. Along MD 36, the byway passes through Lonaconing and Midland, which were company coal mining towns. The Mountain Maryland Scenic Byway continues through Frostburg before passing through Mount Savage and the Cumberland Narrows and ending in Cumberland.