Will this fit my Highlander if it doesn't have a sunroof?

No — this visor is engineered specifically for sunroof models. Non-sunroof Highlanders use a different visor housing. Verify your vehicle has a sunroof before ordering.

Does the visor rod come with this, or do I reuse my old one?

Transfer your existing visor rod from the old visor to the new one. The rod slides into the clip housing the same way it did on the factory original.

What preparation does this need before installation?

None — it's ready to install out of the box. Clip the rod into the mounting bracket above the windshield where your old visor was. Takes two minutes.