The Martha's Vineyard Marathon starts at Martha's Vineyard Regional High School. The first half of the race travels through Correllus State Forest then through Edgartown on Meeting House Way to Atlantic Drive. The course then goes left up Katama Rd through Edgartown with a finish on Beach Rd, over the "Jaws" bridge with a finish in Ocean Park in Oak Bluffs.
The course is mostly flat with a few small rolling sections. The point-to-point course starts at approximately 80 feet and the finish is at just above sea level at 10 feet.