Today, the races consist of the following; The route follows the Tour du Mont Blanc hiking path that is usually completed in 7 to 9 days by hikers.

The path then runs up to the Col de la Seigne (2,516 m) to enter Italy, and follows the ridge of the Mont-Favre (2,435 m) before going down to Courmayeur (1,190 m), the second life base.

It climbs again to the Refuge Bertone (1,989 m) and Arnuva (1,769 m) before reaching its highest point, the Grand Col Ferret (2,537 m), which also marks the border with Switzerland.

The path goes down again to Praz de Fort (1,151 m) via La Fouly (1,593 m) before reaching the third life base, Champex d'en Bas (1,391 m).

Despite the stricter criteria, 10% of qualifying entrants were still denied a place, so the organisers raised entry standards still further for the 2010 event so that selection would be based more on capability and experience than luck of the draw.

The 2020 edition of the race was cancelled due to the coronavirus pandemic, with all registrants automatically receiving a 55% refund and given the option of reserving a spot for 2021, 2022, or 2023.

[13] In 2023, U.S. ultrarunner Corrinne Malcolm reported that she had been fired from her role as a UTMB commentator after four years, and claimed she had been told she was "too outspoken.

"[14] Malcolm, who is also a commentator for the Western States Endurance Run, had previously expressed criticism of UTMB partner Ironman.

In January 2024, elite trail runners Kilian Jornet and Zach Miller sparked further controversy in the ultra-running community when a private email they sent to fellow professional athletes was leaked.

[15] The email suggested finding an alternative race to the Ultra-Trail du Mont-Blanc (UTMB) for 2024, which some interpreted as a call for boycott.

Following public backlash, Jornet clarified that their intention was not to organize a boycott but to raise awareness about concerns within the sport.

[17] While the meeting was described as productive, with both parties expressing a desire for continued dialogue, it was notable that Kilian Jornet did not participate in the 2024 UTMB edition.