SD 44 begins at a junction with US 385 and heads along a curvy road in a general southeasterly direction through the Black Hills National Forest.

A block north of here, SD 44 turns east onto Omaha Street and splits into a four-lane highway.

It crosses Rapid Creek again, then turns southeast and shares a folded diamond interchange with US 16 Truck and SD 79.

[4] After departing from the Rapid City area, SD 44 continues southeast and heads through the unincorporated community of Caputa.

East of the county line, the highway bends to the northeast and enters Interior, where it meets the southern terminus of SD 377.

SD 44 treks east through rolling hills before crossing into Mellette County and leaving the reservation.

In Tripp County, the highways turn south and then back to the east, forming the northern limit of Witten.

The road starts to become more winding and hilly as it nears the Missouri River and Lake Francis Case.

[4] In Douglas County, SD 44 heads east for about 15 miles (24 km) before it arrives at a junction with US 281 south of Corsica.

In Turner County, SD 44 crosses the BNSF Railway[5] and then the west fork of the Vermillion River.

It continues in this direction until it reaches the Lincoln county line, where it curves farther to the southeast toward Lennox.

The highway runs east through rural Lincoln County for about 4.5 miles (7.2 km) before coming to its eastern terminus, a diamond interchange at I-29.