Most major roads in Hackney were established in medieval times, if not Roman, as in the case of Ermine Street (now Shoreditch High Street and Kingsland Road) and Old Street. Ermine Street was an important road northwards from the City. Mare Street was also an important route north and its name probably comes from the Middle English word 'mere' meaning boundary. The north of Mare Street, the Narrow Way, which ran through the old village of Hackney used to be called Church Street, due to the medieval church that stood there. The tower of the church, which dates from the 13th century, is still standing. Other roads known to have existed were Mill Lane (later Mill Field Lane), Well Street, Clapton Street and Dalston Lane.

Roads in medieval times were narrow and uneven and usually in poor condition. For this reason it was better to travel by foot if possible. Only the rich could afford horses anyway. As well as being ridden they were used to carry litters, which were couches that were stretchered between two horses or men.

The busiest traffic in London was on the River Thames. The Thames was the main transport route in London for heavy goods. By the fifteenth century caravels appeared, which were small fast ships with two or three masts which brought cargo from overseas. London's first public transport was also on the Thames in the form of wherries which were small rowing boats. The City of London had only one bridge across the Thames and that was London Bridge. As well as being a busy thoroughfare and lined with houses and shops, London Bridge was also used to display the heads of criminals. This grisly scene is visible on the enhnaced panorama on the right.

Like wise there was only one bridge across the River Lea, at Temple Mills. Tolls were charged for navigating goods along some parts of River Lea. It was a major route for the transport of malt, corn, hay and other produce into London. Tolls were collected on behalf of the River Lea Commissioners, who were in charge of the river and whose office dates back to the fifteenth century, but they were not responsible for the bridge. In medieval times roads that carried national carriage were usually given money for repairs by the Crown. The maintenance of other roads and local bridges were the responsibility of local people and landowners. As traffic increased in the future this became an issue.