Situated at the end of the town's pier, it is adjacent to the terminal for the Wightlink fast catamaran service connecting the island with Portsmouth on the English mainland.

Because of the restricted loading gauge, particularly through the tunnel under Ryde, services are operated by former London Underground stock.

[3] The station originally consisted of three platforms in the form of a pair of islands; a fourth track was added later, opening in 1933.

[4] The station was rebuilt on electrification of the remaining line in 1967, and the new layout consisted of two tracks with three platform faces.

[8][9] From 2021 onwards, the Pier Head (and the rest of the Island Line) is served by new Vivarail D-Train Class 484 EMUs, converted from London Underground D78 Stock.