Passengers can change to ferry service to get to Georgetown and further to the rest of the island via local buses, and so does vice versa.

Before the railway line was extended to Butterworth, all rail services began from Perai, where ferries to Penang Island also departed.

The line to Padang Besar was completed in 1918, allowing the first International Express to run between Prai and Bangkok's Thonburi Station that year.

Train services that provided by Keretapi Tanah Melayu serving KTM ETS and KTM Komuter are: The Butterworth station is also connected to a freight terminal known as the North Butterworth Container Terminal (NBCT) to handle freight cargo from the south at Johor and from the north at Thailand (via Padang Besar railway station).

Until 1 July 2011, the container terminal also sent shipments and received emptied freight rolling stock to and from Kampong Bahru railyard in Singapore near Tanjong Pagar railway station.