Pretty flat course, officially about 60 meters in elevation gain. Most of the course is on paved terrain. Lots of little bands playing, as well as an enthusiastic crowd during most of the run. You're outside of the city centre for a while which gives for some nice views. In the last section there's about 1km of cobbles. If your legs aren't destroyed yet they will be at this point! As of 2022, the marathon is no longer run at night due to logistic problems. I heard many people on a night out in Antwerp got stuck in the city centre when the roads closed, which was one of the reasons to discontinue.