If you think flat PR courses are overrated and prefer your races with a side of suffering (and sweeping views), this one’s for you. Whether you’re training for a mountain race, prepping for the notoriously hilly Big Sur Marathon, or just want to test your grit, these marathons serve up the elevation—and the bragging rights.
Here are some of the hilliest marathons in the United States:
1. Pikes Peak Marathon (Colorado Springs, CO)
- Elevation Gain: ~7,800 feet
- Nickname: “America’s Ultimate Challenge”
This legendary race climbs 13.1 miles straight up to the 14,115-foot summit of Pikes Peak—and then you turn around and run back down. It’s part trail race, part high-altitude suffer-fest, and all kinds of epic.
2. Blue Ridge Marathon (Roanoke, VA)
- Elevation Gain: ~7,430 feet
- Tagline: “America’s Toughest Road Marathon”
This road race takes you over three mountain peaks in the Blue Ridge Mountains. It’s a mix of brutal climbs, sweeping vistas, and screaming downhills that test every muscle fiber.
3. Leadville Trail Marathon (Leadville, CO)
- Elevation Gain: ~6,000 feet
- Altitude: Starts at 10,200 ft and climbs to over 13,000 ft
A high-altitude monster of a race, the Leadville Trail Marathon takes runners through rugged terrain, steep climbs, and rocky descents in the Colorado Rockies. Not for the faint of heart—or lung.
4. Equinox Marathon (Fairbanks, AK)
- Elevation Gain: ~3,285 feet
- Terrain: Trails and roads
Held during the fall equinox, this race blends rugged trails, forest climbs, and a healthy dose of unpredictable Alaskan weather. It’s one of the most scenic and quietly intense marathons out there.
5. Big Sur International Marathon (Big Sur, CA)
- Elevation Gain: ~2,200 feet
- Known For: Stunning Pacific coastline views
Running along Highway 1, this course is breathtaking in every sense. Hurricane Point is the big climb—but rolling hills continue throughout, making this a tough but scenic challenge. Download the RunBetter App to run the Big Sur course from ANY treadmill, anywhere in the world!
6. Mesa Falls Marathon (Ashton, ID)
- Elevation Gain: ~1,200–1,400 feet (net downhill but rolling terrain)
- Known For: Gorgeous mountain scenery & quiet, challenging roads
Don’t let the net downhill fool you—Mesa Falls is no walk in the park. The course includes plenty of rolling hills through forested roads and remote high-country landscapes, with elevation starting near 6,000 feet.
7. San Francisco Marathon (San Francisco, CA)
- Elevation Gain: ~1,100 feet
- Features: Iconic hills, Golden Gate Bridge
While not quite mountainous, SF’s hills are legendary. This urban course includes multiple climbs (and steep descents), including the infamous hill up to the Golden Gate Bridge. San Francisco’s another course you’ll find on RunBetter.
Train Smarter with RunBetter
Ready to take on the challenge of the hilliest marathons in the U.S.? With the RunBetter App, you can train for the world’s toughest courses—right from your treadmill.
This kind of course-specific training helps you build both physical strength and mental confidence. Come race day, you’ll know exactly what to expect—no surprise hills or unexpected climbs.
Download the app today and see what a world of difference course-specific training can make. Check out the full course library here.
