River traffic downstream from Kuala Krai was soon completely replaced by rail travel, and the railway became very popular with what was still quite a large planting fraternity in the interior of the state.

The railway station operated by Keretapi Tanah Melayu (KTM) is on the East Coast Line which runs from Tumpat and Wakaf Bharu (close to Kota Bharu) right through the interior parts of Kelantan and Pahang to Gemas on the west of the peninsula, where it joins the West Coast Line from Singapore to Kuala Lumpur.

Hospital Kuala Krai (HKK) opened in 1917, built on a small hill close to the town.

It is home to a variety of animals, including a male elephant called "Salleh",[13] monkeys, bears, deer and various birds.

The site extends to about 10 acres (40,000 m2), and also includes a Mini Museum displaying photographs and documents relating to the history of Kuala Krai, as well as a number of preserved animals.

This facilitates the prediction of flood levels and lead-times in villages all the way from Kuala Krai to the river estuary.