The road starts at traffic lights by St Leonard's Church in Shoreditch, where it meets the A10 and A5201, which starts its journey west by going under the East London Line. The A1208 heads northeast then east along Hackney Road. The road is largely residential, although there is a brief respite to the left as the Hackney City Farm is passed, and there are some lines of shops.
After going under twin bridges carrying the West Anglia Main Line, with Cambridge Heath station just to the right, the road ends at traffic lights on the A107. The road ahead is the B127.