The line serves the following places:
- Birmingham Snow Hill
- Jewellery Quarter
- The Hawthorns
- Langley Green
- Rowley Regis
- Old Hill
- Cradley Heath
- Droitwich Spa
Passenger services are provided by London Midland between Birmingham and Worcester and beyond, and by Chiltern Railways between Birmingham and Kidderminster only. The latter runs services to London Marylebone in the morning rush hour, which start from Kidderminster rather than Snow Hill, and reverse journeys during the evening.
A triangular junction at Worcester allows a variety of service patterns (see map). Some trains terminate at Shrub Hill, whereas some reverse there before going to Foregate Street. Other trains take the direct curve to Foregate Street avoiding Shrub Hill. Some trains continue beyond Foregate Street to Great Malvern or Hereford.
Trains along this route occasionally also serviced Birmingham New Street, where they terminated. This link was removed, to much local consternation.
Apart from Chiltern's occasional service, only two intercity services are timetabled to use the line each day - one CrossCountry service to Birmingham New Street (via Smethwick Junction and Galton Junction) in the morning and a reverse service in the evening. Neither of these call at any of the stations along the route. During congestion or mainly during engineering works, the line sees much more frequent service as a diversionary route. The line from Worcester Shrub Hill continues to Cheltenham Spa railway station, which is the next calling point for most Cross Country services, and thus offers a convenient alternative when the Lickey Incline is closed.
Several charter trains can often be seen on the line due to the existence of the Severn Valley Railway at Kidderminster, which has a mainline connection.
Between Kidderminster and Worcester, the line speed is 75 mph (top speed of the Class 150 units) except in the following places:
- Kidderminster viaduct- 65 mph
- Droitwich area - 60 mph
- Droitwich station and junction area - 40 mph
- Worcester/tunnel junction area - 25 mph
- Curve near Foregate Street station - 15 mph