It connects rural areas of Hyde, Hand, and Spink counties.

The two highways travel concurrently to the south for approximately 1 mile (1.6 km), while 180th Street continues to the east.

At an intersection with CR 24 (374th Avenue), it enters the southwestern part of Spink County.

Immediately, SD 26 crosses over Medicine Creek and curves to the north.

South of 180th Street, the highway curves to the north-northwest and begins to parallel the western part of Cottonwood Lake.

Just north of this intersection, it curves to the north-northeast and winds its way along the shore of the lake.

East of 384th Avenue, it curves to the east-northeast and reaches its eastern terminus, an intersection with U.S. Route 281 (US 281).