Local television station KVOA described the uphill race as the only long-distance uphill race in the U.S. It had been described as the most difficult road marathon in the world. Runners ran on the General Hitchcock Scenic Byway and started the race surrounded by cacti near the floor of the Sonoran Desert, and as they climbed the mountain, runners transitioned into lush pine forests near the top of the mountain at over above sea level. The New York Times noted that there are other difficult marathons including the Antarctic Ice Marathon which is run on snow and ice south of the Antarctic Circle, the Everest Marathon which starts at the south Everest Base Camp at an altitude of , and the Pikes Peak Marathon which climbs over to the top of Pikes Peak.