A number of small, unincorporated communities lie along or near SD 44, west of Rapid City, including Upper and Lower Hisega, Big Bend, Johnson's Siding, and Placerville. Several tourist attractions also are found on the highway, including Black Hills Caverns (formerly Nameless Cave), Crystal Cave, and Thunderhead Falls, a waterfall created by mining in an underground tunnel. SD 44 connects, via the Norris Peak Road, with Nemo Road between Rapid City, Nemo, and Brownsville, SD, but otherwise has no connections with any other major roads in the Black Hills. The area served by the highway is a major bedroom community for Rapid City.
Highway 44 also traverses the state, with it's eastern end near Interstate 29 right before entering the town of Worthing, South Dakota.