Great Western Railway trains between Maidenhead and Marlow serve the station on the Marlow branch line, but through services to and from London Paddington in peak hours Monday to Friday no longer run.

The station originally had two platforms, acting as a passing loop for trains.

All services at Cookham are operated by Great Western Railway.

The typical off-peak service is one train per hour between Maidenhead and Marlow.

During the peak hours, the service is increased to two trains per hour in each direction and northbound trains runs to and from Bourne End only, connecting with a half-hourly shuttle service between Bourne End and Marlow.