The Trans-Caspian Railway is the main connection. The line runs west to Ashgabat — the journey takes approximately ten hours through the Karakum Desert, a stark and memorable ride through one of the world's largest sand deserts. Eastward the railway continues across the Amu Darya bridge into Uzbekistan. Train frequency is limited, so verify departure times and buy tickets in advance if possible. The journey itself — watching the desert change light from a Soviet-era train carriage — is part of the point.
Buses and shared taxis run to Ashgabat and are faster than the train if the connections work out. Shared taxis to the Farap border crossing operate throughout the day from the city center. There is a small regional airport (Türkmenabat Airport) with occasional domestic flights to Ashgabat, but train is generally more reliable. Note that all independent travel in Turkmenistan requires a guide and a pre-arranged Letter of Invitation; this applies to transport and accommodation booking as well. Work this out through a registered Turkmenistan tour operator before you enter the country.