[2] Starting at a junction with the Tokyo Gaikan Expressway to the north of Tokyo, the expressway follows a northerly course through the plains of Saitama Prefecture and Tochigi Prefecture before entering the mountainous interior of the Tōhoku region.

[4] The route parallels the Tōhoku Shinkansen and Tōhoku Main Line of East Japan Railway Company as well as National Route 4 from its origin in Tokyo to the city of Morioka.

It follows this path winding through the Ōu Mountains to its northern terminus in Aomori at National Route 7 about a kilometer south of the Tōhoku Shinkansen's northern terminus at Shin-Aomori Station.

The standard rate for travelling the entirety of the Tōhoku Expressway in a normal-sized car from Kawaguchi Junction to Aomori Interchange is 13,800 yen, in a kei car the cost is 11,100 yen.

[6] The first section of the Tōhoku Expressway opened on 13 November 1972 between Kanuma and Utsunomiya interchanges.

The expressway was completed on 9 September 1987 when it was extended south to its southern terminus at Kawaguchi Junction.

[7] In October 2004, an experiment was conducted to test the viability of smart interchanges was conducted on the Fukushima-Matsukawa Smart Interchange, which was installed onto the pre-existing Fukushima-Matsukawa Parking Area in the city of Fukushima.

[8] Many sections of the expressway were damaged on 11 March 2011 during the 2011 Tōhoku earthquake and tsunami.