The trail follows Bilk Creek from the rolling mesa up the drainage. Starting by crossing open meadows and riparian habitat, it soon reaches the forest. There it starts to climb, following Bilk Creek up, sometimes steeply past waterfalls on the right. It then crosses several avalanche paths. The trail climbs switchbacks around a large waterfall and cliffs to reach the Morningstar Mine ruins. Just past the ruins the trail enters the wilderness. After a short distance, it begins a series of steep switchbacks up past dramatic cliff-lined waterfalls. Then it enters thicker woods and traverses around to a more open middle basin. After a small creek crossing, it switchbacks up again through willows to timberline and a junction with an old mine road. Bilk Creek trail goes left across a cascade at this point. The road to the right climbs up towards Wilson Peak. The Bilk Creek trail continues on the old road grade, traversing under Gladstone Peak and into upper Bilk Basin. It drops down past a small pond to a crossing of Bilk Creek. Then it climbs yet another set of switchbacks to a saddle and the forest boundary directly under Lizard Head Peak. Here it meets the Cross Mountain trail, which traverses directly under Lizard Head to a junction with the Lizard Head Trail.

Access: Take the Ilium forest access road #625 off of Highway 145 near the base of Keystone Hill, about 4 or 5 miles west of Telluride. Follow #625 past the Animas gravel plant to the Ilium church camp. Turn right across a new bridge leading to road #623. Follow #623 across a long switchback and up onto Sunshine Mesa. Just after you reach mesa top is a junction. Go left at the road junction, continuing to follow #623 for another few miles up more switchbacks to a large meadow. Park along the road just past the meadow at the new Wilson Mesa/Bilk/Lizard Head trailhead. Hike across the old road grade, which has been gated closed to vehicles, for 1 mile to a junction with the Wilson Mesa trail. If you follow Wilson Mesa trail from here it leads down into Bilk Creek and the lower end of the lizard Head/Bilk Creek trail. Or continue another mile on the old road grade to a junction with the Lizard Head/Bilk Creek trail near the Morningstar Mine and the wilderness boundary. Both of these access routes cross private lands. Respect private landowners and stay on roads and trails at all times.