Hill first gained prominence as the troubled hard man Yosser Hughes in Alan Bleasdale's Play for Today drama The Black Stuff (1980) and its sequel serial Boys from the Blackstuff (1982), the latter earning him a nomination for the BAFTA TV Award for Best Actor.

[5] Hill first came to prominence in 1980 as Yosser Hughes, a working-class Liverpudlian man ultimately driven to the edge by an uncaring welfare system, in Alan Bleasdale's BBC Play for Today programme, The Black Stuff, and its series sequel, Boys from the Blackstuff.

[7] Hill appeared in Shirley Valentine (1989),[7] as Joe Bradshaw the husband of Liverpool housewife (Pauline Collins), a former anti-establishment rebel who engages in an extramarital affair.

[10] Hill played Philos in The Scorpion King (2002), starring Dwayne "The Rock" Johnson, Michael Clarke Duncan and Kelly Hu.

[7] Hill played King Théoden of Rohan in the second and third installments of Peter Jackson's epic trilogy, The Lord of the Rings, which were released in 2002 and 2003 respectively.

[11] Hill played a minor role in the 2008 film Valkyrie, as the commanding general of the 10th Panzer Division of the German Afrika Korps, and was a voice actor for the character Sir Walter Beck in the video game Fable III (2010).

[14] Hill appeared as Thomas Howard, 3rd Duke of Norfolk, in the 2015 six-part BBC adaptation of Hilary Mantel's novels, Wolf Hall.

[20] Tributes were paid to him by his Lord of the Rings trilogy co-stars, Boys from the Blackstuff writer Alan Bleasdale and musician Barbara Dickson.