It provides seasonal direct land connections between the communities of Hamilton on the west and Philipsburg and Anaconda on the east via Skalkaho Pass.
[2] MT 38 begins three miles (4.8 km) south of Hamilton, at an intersection with U.S. Highway 93 (US 93).
The road takes an abrupt turn eastward as it passes through Grantsdale, begins its meandering climb southeast along Skalkaho Creek and northeast along Daly Creek through the Sapphire Mountains, turning southeast again before it crosses Skalkaho Pass.
From the pass, MT 38 descends along the West Fork Rock Creek, past the Gem Mountain sapphire mine and crosses Rock Creek near its headwaters, going into Eagle Canyon before making a northeasterly run to its terminus at MT 1, six miles (9.7 km) south of Philipsburg and 23 miles (37 km) west of Anaconda.
Due to heavy snowfall on the narrow winding road, MT 38 is closed from 14 miles (23 km) east of Daly Creek to 16 miles (26 km) west of Gem Mountain, usually from late November until Memorial Day weekend.