The "approach" to this hike is a drive along US 50. From the direction of Lake Tahoe, take US 50 over Echo Summit and continue down the hill past Twin Bridges. After Twin Bridges, but right before Strawberry, look carefully for a creek that flows underneath the highway. There is a small turnout immediately west of the creek (on the right side of the road) alongside highway 50. At last check (May 2002), parking was permitted in this turnout. Crespo also reports that "there is a very small sandy turnout at the left side of the road shortly after the sign marking mile 59.0 of HW 50. There is a "chain required" sign at the end of the turnout (probably not facing the road, unless chains are actually required). From the Tahoe direction, there is a "Passing Lane 4 miles Ahead" sign just opposite to the turnout. For those with a GPS, the turnout is at 38.807805N 120.136722W (WSG-84) "
davidkiene adds that when coming from the west, look for the stone "Mile 43" sign on the side of Highway 50.
After you park, you need to find the trailhead. When I've done this hike, I have started up the hill on a use trail immediately on the right (east) side of the creek. This trail climbs very steeply up past some waterpipes and then angles right (away from the creek) onto the hillside, where the trail becomes easier to follow. Others have commented that an easier trailhead is found about 150 yards above the creek, just next to the rectangular black and white sign marking mile 59.0 of HW 50. Apparently someone has sprayed painted a green "T" on a rock next to the place where the trail starts. This is a good trail (although also very steep). Whichever trail you choose, if you find yourself bushwhacking, you are not on the trail.
Overview The Rocky Canyon route up Pyramid Peak is probably the greatest vertical climb in the Tahoe Sierra. Starting from a base elevation of 5,900', the route climbs up nearly 4,100' to the summit of Pyramid Peak. It is also the shortest route to the summit from a roadway, and thus sees a reasonable number of daytrippers.
Winter Access Because the Lyons Creek trail is not plowed, and because the Horsetail Falls route is somewhat treacherous in ice and snow, Rocky Canyon is the preferred route to the summit of Pyramid Peak in winter. Magnificent skiing can be had down the SE ridge, particularly in the early to mid-spring. However, because of the large elevation gain and the route's southerly aspect, it must be timed properly. Go to early, and the snow isn't properly corned up near the summit. Go too late, and the bottom of the run can present 1,500' feet of dry hiking before snowline. Even in mid-winter, the lower slopes near US 50 can be devoid of snow, exposing a dry bushwack in the heart of ski season.
The Route From US 50, the trail passes upwards very steeply through some brush and forestland for a couple of miles. Although it is sometimes difficult, try to follow the use trail on this section. The alternative is a murderous bushwack up a steep mountainside above the highway. As the trees thin out above 8,000', the route should become obvious -- head towards the broad SE ridge that drops down from the blocky summit of Pyramid Peak. The ridge is not difficult to follow, but there is some large talus to contend with along the way.
I recommend long pants (hiking pants) for this little jaunt. I don't want to discourage folks from the hike, but there are some Tahoe-style bushes to contend with. Pants can make the difference between an enjoyable hike and a scratched to sh*t set of legs.
If you have information about this route that doesn't pertain to any of the other sections, please add it here.