Piatra Neamț has a railway station on the line from Roman (which connects to the main Bucharest–Suceava trunk line). The journey from Bucharest by train takes around 5–6 hours with a change at Roman; from Suceava it is about 2–3 hours. CFR Călători runs the services and timetables are available on their website.
Buses (maxi-taxi and coach) are often faster and more frequent than trains for travel within northeastern Romania. Services run from Iași (about 2 hours), Suceava, and Bucharest. The bus terminal in Piatra Neamț is near the train station.
By car, the city is reached via the E85 main road that runs north-south through Moldavia, and from Transylvania via the mountain road through the Bicaz Gorge — a spectacular approach across the Carpathians.