It runs from the Perimeter Highway (PTH 100) at Winnipeg to the border town of Emerson, ending at Manitoba Highway (PTH) 75 at Emerson, near the Canada–United States border.

PR 200 begins as a continuation of Winnipeg Route 52 (St. Mary's Road) immediately south of the Perimeter Highway in Winnipeg and runs southward parallel to the flood plain of the meandering Red River.

Agathe before leaving the Red River to run directly south through a heavily agricultural area to the community of Dominion City.

At the south end of Emerson, PR 200 stops at an intersection only 3 metres (9.8 ft) from the United States border and 150 metres (490 ft) from the former Noyes–Emerson East Border Crossing, barricaded since 2006.

This intersection was PR 200's original junction with PTH 75 and southern terminus.