The mainly dual-carriageway 12.5-mile (20.0 km) stretch between The Pentagon Island in Derby and the Queen's Medical Centre in Nottingham was named Brian Clough Way in 2005 to honour the late Derby County and Nottingham Forest football manager Brian Clough.

It passes the leisure centre on the right, then veers right at a junction with the B5045 (which continues on the main road), where it enters the City of Stoke-on-Trent.

As Hartshill Road, it passes the Royal Stoke University Hospital and enters the town of Stoke-upon-Trent.

It passes through the villages of Kingsley and then Froghall where it crosses over the Churnet Valley Railway and Cauldon Canal, before meeting the A521 and B5053 (for Ipstones).

Entering Derby as Ashbourne Road, it meets the busy A38 at a roundabout, and Esso Mackworth Service Station.

From here to the dual-carriageway is a popular pub crawl, with many student residences close by for the University of Derby, such as St Christopher's Court.

From the traffic lights at the eastern end of both, the road becomes Ford Street, passing the Friargate Studios.

Further east, it is the main east–west route from Derby to Nottingham, connecting the two cities via the busy junction 25 of the M1 at Sandiacre.

The junction at the Queen's Medical Centre with the A6514 Middleton Boulevard was originally a roundabout, but became a GSJ, costing £3.7 million in late 1983.

The former route through Nottingham is now the A6200, then down Angel Row, Wheeler Gate, Lister Gate then through what is now the Broadmarsh Centre and past the railway station on Carrington Street, through The Meadows as Arkwright Street to a point near the A60/A6011 junction, over Trent Bridge and along the current A6520 Radcliffe Road.

There is a junction for Abbey Street (A6005 – former A453) which was originally a much smaller temporary flyover, but was improved in June 1990 at a cost of £5.5 million, which is where the former A614 terminated.

It enters the borough of Rushcliffe where it crosses the former Great Central Main Line and meets the A60 (for Ruddington and the Nottingham South Premier Inn), then the A606 at busy roundabouts.

This section from the A606 roundabout, near the Wheatcroft Garden Centre, to the Dunkirk junction (current A6005, then the A453) – the Nottingham Ring Road – was opened in 1963 as mostly single carriageway.

It passes close to Tollerton Airfield and a large Morrisons (former Safeway), and crosses the Grantham Canal meeting the former route (A6011) at a busy roundabout near the Bridge pub.

There is a left turn for Scarrington, then it passes a HM Prison Whatton at Whatton-in-the Vale, near to where it crosses the River Smite.

It passes the Vale of Belvoir hotel, and after Elton where it passes the Manor Arms,[9] it enters Leicestershire, the district of Melton, and the Vale of Belvoir at the start of the Bottesford bypass, which opened in February 1989 with an extremely wide concrete £3 million (£9.43 million as of 2023),[7] 3-mile (4.8 km) two-way road.

[10] Until only recently this busy trunk road was part of the High Street in Grantham; now it is diverted alongside the East Coast Main Line on Sankt Augustin Way, which is also the A607.

South of the town, it meets the B1174 at traffic lights near the Spotted Cow, with the Total St Leonards Service Station on the left and Pizza Hut and McDonald's on the right.

It follows a 1-mile (1.6 km) bypass, which opened in the early 1990s, to the north becoming Bicker Road and there is a left turn for Northorpe.

It enters the borough of Boston just before the 1+1⁄2-mile (2.4 km) bypass to the south of Bicker, which opened in the early 1990s, where it meets the B1181 and becomes Donington Road.

There are some crossroads with King Street, then Marriotts Mazda garage on the left before a roundabout with the A16 Spalding Road (which it overlaps through Boston).

In Boston, it follows the inner relief road, where it becomes John Adams Way, which crosses the River Witham (where it is tidal) on the £220,000 Haven Bridge, which opened in June 1966.

It passes the Esso John Adams Way Service Station on the right, close to two speed cameras in either direction and overshadowed by the floodlights of Boston United.

There are traffic lights at a roundabout with the A1137/B1183 (for Horncastle), where the inner-relief road ends near the Red Cow Hotel.

It passes Holy Trinity church on the left, and the Mill Inn which is close to Boston High School.

It crosses the Hobhole Drain at Haltoft End where it passes the Freiston Centre for Environmental Education and the Castle Inn.

It meets the B1451 roundabout in the centre of Skegness near a Morrisons (former Safeway) superstore and the railway station becoming Roman Bank.

After the junction with the A158 (from Lincoln), it is no longer a trunk road, and passes the Total North End Service Station on the right.

It passes through Ingoldmells and the primary school as Skegness Road, heading slightly westwards through Hogsthorpe as South End then High Street.

At Mumby, it meets the B1449 as Station Road and passes the St Thomas of Canterbury church and Red Lion, with a left turn for Cumberworth.