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Follow the trail up the Middle St. Vrain valley to about 10,800', then leave the trail and climb a gully (snow in June, loose scree later in summer) up to a shoulder east of the summit of Elk Tooth at 12,100'. This gully is not pleasant after the snow melts out, but the best footing is to the right side on grassy or rocky areas. Follow the ridge west over a few false summits to the summit of Elk Tooth. One false summit even contains a false summit register! The actual summit of Elk Tooth is stunning, as it sits above a steep cliff on the south face. The real joy in this route, however, is that you can continue on to Ogalalla Peak. See the East Ridge of Ogalalla Peak for details.