It is situated at milepost 300.75 miles (484.01 km) from London Paddington, which is measured via Bristol Temple Meads, although most trains use the shorter route via Newbury.

A contemporary report tells us that: the passenger station here is a handsome stone building, one hundred and thirty feet long, with large projecting roof; and containing in the centre of the building a spacious booking office, having separate entrances for first, second and third class passengers.

The whole of the space occupied by these rails and platforms are covered by a double roof, of the respective spans of fifty-seven and forty-one feet, with iron tie and suspension rods on a novel principle.

The West Cornwall Railway kept its station at Newham Quay to handle goods traffic to the town (Truro did not become a city until 1877) and waterfront, the branch crossing the Falmouth line on the level just beyond Highertown Tunnel at Penwithers Junction.

It was at this time that a third footbridge was added across the station in place of the level crossing, access to this being from the road rather than the platforms.

Truro station is 300 miles 63 chains (300.79 mi; 484.1 km) from the zero point at London Paddington (which is measured on the historical route via Box and Plymouth Millbay).

[10] The main entrance to the brick-built station is on the south side of the line, leading directly to the platform used by trains to Penzance.

Some trains run through to or from London Paddington, including the Night Riviera overnight sleeping car service, and some through to Cardiff Central, as well as one to Gloucester daily.

There are a limited number of CrossCountry trains providing a service to Edinburgh Waverley via Birmingham New Street and Leeds in the morning, and a few towards Penzance in the evening, including one originating at Aberdeen.

The West box, which was situated on the north side of the line near the entrance to the engine shed, was closed on 7 November 1971 when the East box, situated on the same side of the line just east of the level crossing, was renamed as just "Truro".

[17] The adjacent signal boxes are at Par railway station to the east, and at Roskear Junction, Camborne, to the west.