Fianarantsoa sits on Route Nationale 7, roughly 400 km south of Antananarivo, making it a natural stop on any overland journey down the spine of Madagascar. Taxis-brousse (shared minibuses) connect it to Tana, Antsirabe, Ambalavao, and points further south; they all depart from the busy station on Rue MDRM.
The other way in — or out — is the narrow-gauge train to Manakara on the east coast. The FCE railway winds through mountain rainforest and rice paddies, stopping at every village along the way. The journey takes anywhere from six to ten hours depending on conditions, and the scenery is spectacular throughout. Departures are infrequent and the schedule unreliable, so check locally before counting on it for a connection.