I did an out-and-back ride of about 15 miles in July of 2005. I started at the campground and missed a turn and ended up heading back to Medora. Heading back to Medora was mostly downhill it seemed.
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You can access this trail by riding out to the western exit of Medora under I-94 or you can get on it at the Buffalo Gap Campground which is about 6 miles west of Medora and it starts right at the day-use parking lot.