Pyatigorsk sits at the centre of the Caucasian Mineral Waters region, well connected by rail and air. The nearest airport is Mineralnyye Vody (MRV), about 25 km away, with flights from Moscow and several other Russian cities. From Moscow by rail, the journey takes roughly 24 hours on the overnight trains that run via Rostov-on-Don; Pyatigorsk has its own station on the main line.
By bus, there are connections from Stavropol, Vladikavkaz, and other regional centres. Within the Mineral Waters group, marshrutky (shared minibuses) run frequently between Pyatigorsk, Kislovodsk, Zheleznovodsk, and Yessentuki.