The B118 heads east from Shoreditch, through Bethnal Green, towards the A12 at Old Ford.
It starts on the A1208 Hackney Road in Shoreditch and heads east along Columbia Road before zigzagging to reach Gosset Street. It passes under a bridge connecting the two halves of Oaklands School and then reaches the A107 Cambridge Heath Road.
The B118 multiplexes south along the A107 for one block before restarting along Old Ford Road at its original 1922 western end. It crosses the Grand Union Canal and skirts Victoria Park before ending on Parnell Road, which is numbered B142 to the right; the other two directions are unclassified.
Originally the B118 continued ahead along the remainder of Old Ford Road to end on Wick Lane, which was the B114 in 1922. That road was downgraded and the eastern end of the B118 severed with the building of the East Cross Route, now numbered A12.