The A453 road was formerly the main trunk road connecting the English cities of Nottingham and Birmingham. However, the middle section of this mainly single-carriageway road has largely been downgraded to B roads or unclassified roads following the construction of the parallel M42-A42 link around 1990. The M42 was originally meant to pass further north than it does, and to join the M1 at Sandiacre in Derbyshire. The M42/A42 does not enter Derbyshire, but instead joins the M1 closer to the A453 junction at Kegworth. The A42 shadows the former A453 from Appleby Magna to Castle Donington. The road historically connected the East Midlands with the West Midlands.

The southern stretch of the existing A453 runs as a non-trunk route from the A34 in north Birmingham under the M6 motorway to the A452 road, and on through Sutton Coldfield. Historically this section was classified as the B4139 and was upgraded in 1935. It starts at the point where the A34 crosses the Chase Line at Perry Barr railway station. On the right hand side is Birmingham City University and the road passes through Witton. As Aldridge Road it becomes a dual carriageway and crosses the River Tame. To the left is Perry Park, and it passes under the M6, becoming College Road. It crosses the Tame Valley Canal, and there is a left turn for the dual-carriageway Kingstanding Road (B4138) in Perry, the former Roman road Ryknild Street. In Upper Witton there is a roundabout and Perry Barr fire station is on the left next to Perry Common library, with The College High School on the right, and there are a crossroads and roundabout, with left turns for Kingstanding, and the road passes through Perry Common. On the right is St Mary's College, Oscott, a Roman Catholic seminary of the Archdiocese of Birmingham, and the road meets Chester Road (A452) at a crossroads.

In Boldmere the road continues after the crossroads as College Road, but becomes Jockey Road where the B4149 meets from the left at a roundabout at New Oscott. It crosses the Cross-City Line with Sutton Coldfield Grammar School for Girls on the left. Near St Peter's Church in Maney and the Horse and Jockey pub it runs concurrently with the A5127 through the town centre of Sutton Coldfield, splitting in two one-way sections at a roundabout, and passing Sutton Coldfield railway station. It passes over and under two railway lines, then passes the police and fire station, with Birmingham Metropolitan College (former Sutton Coldfield College) and Bishop Vesey's Grammar School on the right.

The original route of the A453 separates from the A5127 at the Tamworth Road junction at Doe Bank, passing under the Cross-City Line. It passes a crossroads, with Moorhall Golf Club to the left, and Whitehouse Common Road (B4148) to the right. It crosses the M6 Toll, then Collets Brook, where it enters Staffordshire, and the district of Lichfield at Hints. When the A38 was dualled, the A453 was moved to the west, to meet at the Bassetts Pole roundabout. This was not only the meeting point of the Birmingham to Nottingham road, and the A38 (former A446), but is also the meeting point of Warwickshire, Staffordshire and the former West Midlands county. At the roundabout is the Bassetts Pole Harvester, and a McDonald's. As a dual-carriageway trunk road at Carroway Head, it meets the B4151 from the left (for Roughley), and becomes the parish boundary between Hints and Drayton Bassett, and a single carriageway, as Sutton Road. It is only a trunk road for 3 miles (4.8 km) until it meets the A5, after crossing the Heart of England Way, Bourne Brook and the former A5, now the B5404, at Mile Oak, Fazeley.

As the non-trunk Bonehill Road it crosses the Birmingham and Fazeley Canal, where it enters the district of Tamworth. It meets the A51 at a large roundabout, and continues as the dual-carriageway Riverdrive, concurrent with the A51, meeting the A4091 (for Drayton Manor Theme Park) to the south, then crosses the River Tame. The A51 leaves to the south at a large roundabout-shaped junction, partly Ankerdrive and Bolebridge Street, known as The Egg which straddles the River Anker, and passes the Tamworth Odeon. It continues northwards as Saxondrive, an inner ring road for Tamworth, with a roundabout for Tamworth railway station then continues westwards as Offadrive to meet its former route through Tamworth (partly the B5493), where it meets the A513 near the bridge over the West Coast Main Line. King Offa was the King of Mercia, a Saxon kingdom, with its capital as Tamworth. Previously the A453 continued along Bonehill Road then across Lady Bridge and along Aldergate in Tamworth town centre.

The downgraded former middle section continued through Tamworth and Ashby-de-la-Zouch to the M1 motorway. Prior to the construction of the M42 the road was north of its current route, running through Castle Donington, Long Eaton and Beeston. The section through Castle Donington is now unclassified south of the A50, north of the A50 it is the B6540, and from Long Eaton to Nottingham is part of the A6005.

The only part of the section between Tamworth and the M1 now designated as the A453 is a short new link west from the limited-access A42 junction 14] to the old route in North West Leicestershire. From the A42, the downgraded section of the proposed M42, it follows Moor Lane as a non-trunk road. This route was formerly the A447, and continued southwards to Swannington, its present terminus. The A447 also went through Tonge. It meets the former route of the A453 at a T junction, which it follows for one mile. It passes through Isley Walton (Isley cum Langley) as Walton Hill. The Donington Park motor circuit is close to the north and there is a left turn for Castle Donington, which is the former route. The road is dual carriageway for a short section and meets a roundabout. The route follows the southern edge of East Midlands Airport, along the former B5400 to Charnock Hill. There are two right turns for Diseworth, and at Long Whatton and Diseworth it leaves the former B road (which would have passed through one of the terminal buildings, across the airfield, to Kegworth), and continues on a new section of road when the airfield was extended from the former RAF Castle Donington in the mid-1960s. Continuing as Ashby Road, there is a roundabout for the Pegasus Business Park, home of Central Networks East (former East Midlands Electricity, owned by PPL Corporation since April 2011. This section also serves several large hotels associated with the airport.

The A453 becomes trunk road again just north of M1 junction 23A where it joins a spur of the A42 at a roundabout on the parish boundary of Kegworth, which was built when the A42 opened. Later the Donington Park services were added in July 1999. It runs parallel to the motorway to M1 junction 24, to link to the motorway and the A50 road. On the opposite side of the M1 from Molehill Farm, on 8 January 1989, the Kegworth air disaster took place. There is a right turn (Ashby Road) for Kegworth, which is the continuation of the former B road route across the airfield. This section of the A453 from junction 24 of the M1 to the airport was opened as the £250,000 Kegworth Link Road on 3 September 1975 by a local county councillor, Mrs Kathleen Wildsmith. The road was built by Galliford and Sons. Previously traffic went straight through Kegworth. There are plans to bypass Kegworth from the south, to join the A453 roundabout at the Donington Park services roundabout.