The line was promoted by Fife Council and the South East Scotland Transport Partnership (SESTRAN).

Carbon dioxide produced by the distillery at Cameronbridge was carried by rail, whilst coal slurry from collieries around Fife was delivered to Methil power station using the line.

[3] The line was unused entirely until 2011, when one mile of the route was reopened to serve a loading point for the opencast coal mine at Earlseat.

[9] The catchment area of the line, which includes parts of the East Neuk of Fife, is around 43,000,[10] and as such was identified by Campaign for Better Transport as a priority 1 candidate for reopening.

There was a significant increase in campaigning in 2008, when the Airdrie–Bathgate rail link and Borders Railway were being authorised by the Scottish Parliament.

[13] It was hoped during the 2008 studies that coal and whisky freight could be carried on the line, and that the developments will encourage regeneration of the area.

[1][13] Campaigning for the reintroduction of passenger services continued and in 2015 Fife Council prepared a second STAG[note 1] Report.

[19] In May 2021 sleepers for the line were delivered[20] and at the end of July 2021 work began on removing the old abandoned trackwork.

[21] The main delivery phase of the project kicked off in March 2022[22] and work at Leven station began in February 2023.

[25] Initially upon opening, the service level is one train per hour between Leven and Edinburgh Waverley, calling at Cameron Bridge.