As of 2019, all but 42 km (26 mi) has been paved, mostly for expediting the removal of timber from the region, which, like most of British Columbia, is afflicted with pine beetle infestations.

Highway 20 is famous for the portion of the westernmost stretch next to Young Creek Canyon, between Anahim Lake and Bella Coola, known as the Hill or The Precipice.

Tourists who have driven to Bella Coola from Williams Lake have been known to refuse to drive back and have had to be taken out by boat or float plane.

It rises gradually for 23 km (14 mi) to the crossing of the Fraser River at Sheep Creek Bridge, from which it ascends via a series of steep switchbacks to the Chilcotin Plateau.

At 36 km (22 mi) it passes the site of the Williams Lake LORAN-C Tower, part of the maritime navigation system.