The crossing of the River Stour was probably the swine-ford that gave rise to the placenames Kingswinford and Oldswinford, and later to the name Stourbridge.

There are local accesses for the villages of Belbroughton, Clent, Romsley and Holy Cross.

Following a roundabout in Hagley the A491 is concurrent with the A456 for a short period before heading north towards Stourbridge.

The original route of the A491 resumes on the northern side of the Stourbridge ring road.

This final section is entirely single carriageway, apart from a short distance between the staggered junction with the A461, in an urban environment causing major delays.