PTH 45 travels through the Waywayseecappo First Nation, crossing a lake (via causeway) and the Birdtail River, as well as passing through the main business district of the reserve.

The highway then goes through several switchbacks as it leaves the First Nation and travels through the town of Rossburn, where it has an intersection with PR 264 (Main Street), and the community of Vista.

Entering the Rural Municipality of Harrison Park, PTH 45 passes by Sandy Lake, where it junctions with PR 250, and Rackham, where it junctions with PR 270, as it travels past several lakes over the next several kilometers, crossing one of them via a causeway.

The highway crosses the Trans Canada Trail, entering the Rural Municipality of Clanwilliam - Erickson, and coming to an end shortly thereafter at an intersection with PTH 10 (John Bracken Highway) 5 kilometres (3.1 mi) north of Erickson.

This, along with some very sharp curves in the western section between Elphinstone and Russell, increased the travel time along this route.