The Course des Crêtes du Pays Basque begins and ends in the village center of Espelette, in the French Basque Country. The event commences Friday evening with a 7.5 km climb from Espelette to the Mondarain summit, limited to 150 participants. Saturday features trail races, walks, a Nordic walk, and guided hikes. The primary running distances are 7 km, 15 km, 21 km, and 30 km, with the longer mountain courses reaching up to 1500 meters in elevation.
The courses emphasize climbing over flat speed, with specified elevation gains of 500, 650, 900, and 1500 meters for the various races. Poles are prohibited in the 7 km, 15 km, 21 km, and 30 km races. The 15 km Nordic walk requires appropriate Nordic poles. The event accommodates non-runners with a guided hike, a free Joëlette hike, a self-sufficient 15.5 km hike, and the 16.7 km MIAM-MIAM walk. The MIAM-MIAM walk includes a meal at a sheepfold and has a 300-person limit. Following the night race, participants walk one kilometer back toward Espelette before boarding shuttles. Showers, massages, and a buffet featuring grilled and cold food are available under the covered market.