Pikwitonei is located along the Hudson Bay Line, operated by Omni Trax, some 304 kilometres by rail Northeast of The Pas and 48 kilometres approximately Southeast of Thompson. The railway provides the only all-weather surface linkage. The railway reached Pikwitonei in 1914 and the community served as a division point until 1972.
Trapping is a vital economic activity. Commercial fishers harvest on six nearby lakes and deliver fish to the Wabowden fish station. Wild rice has been planted in some of the surrounding area.