The race starts in front of the West Virginia State Capitol on the Kanawha Boulevard.
The final 7 miles (11 km) are flat; runners go past the West Virginia State Capitol, along the Kanawha River, before finishing at Laidley Field.
Cohen wanted to create a race that coincided with the annual Sternwheel Regatta, so he teamed up with city leaders and police to find a route.
The race ended up being 15 miles (24 km) quite by accident, as Cohen's main focus was to orientate the race around some of Charleston's most famous landmarks, such as the State Capitol, the Kanawha riverbank, the East End, West Side, and South Hills.
Though the Sternwheel Regatta retired in 2008, the Distance Run continues as an independent event.