The region features the most rugged side of Mount Adams, including canyons and the Great Gap section of the Mount Adams circumnavigation route, a three-mile trail-less section over two great canyons and many difficult glacial creeks.

[2][3] The Mount Adams Recreation Area offers activities such as hiking, camping, backpacking (at specific campsites), picnicking, and fishing.

The Round the Mountain Trail extends from the Pacific Crest Trail on the southwest side of the Mount Adams Wilderness, and travels east over the A.G. Aiken Lava Bed before crossing into the Yakama Nation Mount Adams Recreation Area.

All of the roads after the short section known as the Mount Adams Recreation Highway is gravel and dirt, and is known to be extremely rough and often only suitable for trucks or high clearance vehicles.

Crampons, ice axes, and ropes are needed on all routes here because of the glaciers, crevasses, and jagged cliffs found on Mount Adams' rugged east side.

Climbing Mount Adams can be dangerous for a variety of reasons and people do die in pursuit of the summit.