Unlike most of its trailless neighbors, this summit sits right on a marked route. The Pine Hill-West Branch Trail traverses the mountain, and the true high point is a short step off the trail to the east. From the Rider Hollow trailhead, the Balsam Mountain Loop covers 5.51 miles and can be walked in either direction. A lean-to appears about half a mile from the parking area, and there are stream crossings that start bridged and end as rock-hops.
The summit walk is long, and a false summit comes before the real one. Along the ridge there is one good viewpoint, and a pointed rock sits about 50 feet off the trail. Balsam fir and red spruce grow on the upper mountain in small stands rather than a continuous cover. Lower down, the slopes carry beech, birch and maple, and most of the upper forest remains first growth.
Winter brings icy ledges and drifts on the ridge, and the Rider Hollow lot is plowed. Balsam is one of the four peaks that the Catskill 3500 Club requires a second, winter ascent of, alongside Slide, Blackhead and Panther. A longer loop can add neighboring summits.
