Twenty universities, which belong to The Inter-University Athletic Union of Kanto (関東学生陸上競技連盟, Kantō gakusei rikujō kyōgi renmei), can participate in this Ekiden.

As part of the traditional 53 Stations of the Tōkaidō, the runners will face a significant uphill climb at Gontazaka at the 13 km mark.

The first 9 km of leg is marked with a gentle descent as the course gradually departs the urban areas towards the Shōnan coastline.

The runners join National Route 134 at Chigasaki, and travel along the coastline with Mount Fuji in front of them and Sagami Bay to their left.

Leg 3 finishes after the runners cross the Shonan Bridge over Sagami River, and reaches the Hiratsuka relay station on the coast.

The shortest flat section of the race, leg 4 leads runners parallel to the Tokaido Main Line past towns of Ōiso and Ninomiya, before crossing the Sakawa River into the heart of Odawara.

Finally, the runners run through the town of Moto-Hakone under the Torii of Hakone Shrine at 19 km, and reach the finish line at Lake Ashi.

While almost all competitors forego tank tops and opt to dress in long sleeved apparel to combat the low temperatures, leg 5 sometimes sees runners fall to conditions such as hypothermia and hypoglycemia due to its trying nature.

This leg often sees uphill specialists from each team being deployed, with many often only running this section for their universities throughout their collegiate career.

As the sun rises throughout the course of leg 7, the difference of temperature between the start in Odawara and the finish at Hiratsuka is the largest out of all other sections.

Because of the symbolic importance of physically relaying the Tasuki to each teammate throughout the race, emotions often run high when teams fail to do so.

After crossing Nihonbashi, the race returns and concludes in front of the Yomiuri Shimbun Building, where the finish line awaits.

The spectating crowds grow gradually as the race progresses through leg 10, and runners have to face strong winds between tall buildings as they enter more built-up areas of Tokyo.

As the final runners of each team close out the race, their teammates await them at the finish line in celebration and reflection.

His enthusiastic idea of bringing up a runner who could compete in the world became the driving force of establishing Hakone Ekiden.

When Kanaguri was a Tokyo Koto Shihan school (Koshi) student, he participated in Olympic Games in Stockholm in 1912 as one of the representative Japanese marathon runners.

Reflecting this active atmosphere, the Japanese sports society, including ekiden one, were developing great challenging spirits at that time.

This centralization has caused concerns about equity, with universities from other regions frequently calling for the race to open its entry eligibility nationwide.

Although the original purpose of the Hakone Ekiden was to "develop long-distance runners from Japan capable of competing on the world stage," in reality, many athletes treat the event as their ultimate goal.