Marathon Trail Lago di Como begins in Menaggio’s lakefront square, situated at 201 meters above sea level. From there, a select group of runners heads directly into the western Prealps overlooking Lake Como. The series focuses on mountain running. The K42 course spans 42 km with approximately 2,400-2,500 meters of elevation gain. The K21 covers 21 km with roughly 1,450-1,500 meters of climbing. The Acqua Trail includes a 2 km swim followed by a 10 km mountain run featuring 500 meters of ascent.
The terrain is predominantly rugged, with about 82% of the courses consisting of mule tracks or trails. Short sections include asphalt, cobblestone, and concrete mountain roads. Menaggio and Plesio are the host towns. The K42 has a 10-hour time limit. Entry is limited to 100 runners for the K42, 100 for the K21, and 30 athletes for the Acqua Trail, indicating a focused competition rather than a large festival. Aid stations provide bottled water and individually wrapped food. Finishers are given a sealed bag of food and drink. Showers are available, and awards are presented on stage for overall and age-group rankings.