At 103.6 kilometres of length, the line runs close to the southern bank of the Lower Elbe river.

The Lower Elbe Railway is a main line since 1964 and is currently listed as Kursbuchstrecke 121.

The line is part of the Strecke 1720, with the kilometrage starting at Lehrte near Hanover.

The line features two tracks on most sections, except between the stations Himmelpforten and Hechthausen.

The trains between Cuxhaven and Hamburg have been operated by metronom since late 2007.