It begins at MT 200 in Plains and ends at U.S. Highway 93 (US 93) in Elmo; all but the first 7.5 miles (12.1 km) are within the Flathead Indian Reservation.

[1] It serves as a key link in two alternate routes between Spokane, Washington, and Kalispell.

Initially, the highway winds northeasterly as it climbs through steep forest terrain before descending towards the plains again.

About two miles (3.2 km) north, it meets Little Bitterroot Road, which connects to S-211 and the city of Ronan.

MT 28 was originally routed through Hot Springs and Camas as seen on the 1935-36 state maps,[2][3] with northbound traffic entering Hot Springs at the southwest corner of the city (today's Old Hot Springs Road), turning east on Central Avenue and north on Spring Street, and exiting the northeast corner of the city as it headed north and east to Camas (today's Chisholm Road).