Prior to the creation of the Cross-City Line, the northern half of the route from New Street to Sutton Coldfield and Lichfield had a well used regular suburban service, which had been switched from steam to diesel multiple unit (DMU) operation in 1956, leading to a large increase in usage.

[10] In the early-1970s the West Midlands Passenger Transport Executive (WMPTE) gained responsibility for managing and planning the local railway network in the West Midlands, and they set about looking for ways it could be improved: The WMPTE Passenger Transport Plan of 1972 recognised the need for a cross-city rail service, and especially an improved service to the south of Birmingham with new stations to serve the growth areas in the south of the city.

[14][11] Services initially ran on a 15-minute frequency between Longbridge and Four Oaks via Birmingham New Street, with an hourly extension to Lichfield City, using refurbished Class 116 Diesel multiple units.

[15][14][16] By the late-1980s, the elderly diesels operating the service were becoming increasingly unreliable, and the WMPTE (now reorganised as Transport for West Midlands, formerly Centro) pressed for electrification.

The decision to electrify the line was made on 7 February 1990 by the then Transport Minister Cecil Parkinson during the campaign for a by-election in the Mid Staffordshire constituency.

A new fleet of Class 323 Electric multiple units were introduced to work the electrified line, and replace the elderly diesels.

[17][14] The cost of the electrification scheme was estimated at £64.5 million (equivalent to £165,950,000 in 2023),[12] of which around 70% was funded by Centro, and the remainder by the Regional Railways sector of British Rail.

In November 2013 a scheme was approved to construct a new passing loop at Alvechurch to allow the service to be increased to three trains per hour.

[25] Post-pandemic the Cross-City Line weekday service has been reduced from 6 to 4 trains per hour in each direction usually operated by two sets of Class 730s, forming 6 cars.

[27][1][2] In the December 2024 timetable[28] the off-peak weekday and Saturday service on the core section of the line between Four Oaks and Longbridge comprises four West Midlands Railway trains per hour in each direction.

The service consists of: Between Birmingham New Street and Barnt Green, the Cross-City Line is contiguous with the Cross Country Route.

There are long-standing proposals for the re-introduction of local trains on the Camp Hill line[29] (effectively a loop between Birmingham New Street and Kings Norton).