The road runs parallel to Manitoba's border with the United States for a distance of 218 kilometres (135 mi), nearly half the province's length.

[1] PR 201 begins near Snowflake, approximately 5 kilometres north of the border.

The western section of the road is gravel and runs a jagged line, at one point running along the border.

At Osterwick, PR 201 becomes a paved, two-lane highway and continues due east through the town of Altona to PTH 75 at Letellier.

East of Letellier, it crosses over the Red River and passes through the Roseau River Anishinabe First Nation Indian reserve.