The road starts at a roundabout on the A509 just north of the River Nene, where that road bears left to join the A45. We continue north on its old route along London Road into town. We pass an out-of-town retail park and then the grounds of Wellingborough School, so the road never actually becomes residential. Presently we start descending and pass a few houses to enter the town centre. We meet the one-way ring road, either the A5128 or A5193, at traffic lights.
Following the A5193 in this direction is straightforward, following a straight road for about a quarter of a mile. We continue ahead into Sheep Street, which climbs to meet the A5128 towards the west. After this we need to keep in the left-hand lane – right is for the eastbound A5128 and the continuation of the ring road – to head out of town along the High Street, which becomes two-way once we've left the ring road. Southbound A5193 traffic has drawn the short straw and has to follow the remainder of the ring road to pass to the east of the town centre; this takes about three times the distance and is explained in detail on the A5128 page.
The A5193 heads out of town through the suburb of Hatton Park. There's a brief semi-rural section as it crosses a stream but we then climb through another suburb. Here, however, no houses front onto the road. After going under a footbridge we descend to a roundabout where we meet the A509 once more and the A5193 ends. The A510 northeastern bypass also meets us here.