Dhuusamarreeb has a small airport with intermittent domestic flights — when they run, they connect to Mogadishu and Galkayo. Schedules are unpredictable, security checks heavy, and operators come and go. Most arrivals are by road, on the long inland route between Mogadishu and Garowe, which passes through territory periodically held by al-Shabaab.
Independent overland travel is strongly discouraged. The few foreigners who reach Dhuusamarreeb usually do so as part of UN, NGO, or diplomatic missions, with armed escort and pre-arranged convoys.