[3][citation needed] Nishijima made his debut in the contemporary detective television drama series Hagure Keiji Junjōha in 1992.

In 1993, Nishijima gained public recognition for his portrayal of a gay character in the massive hit television series Asunaro Hakusho, which co-starred Takuya Kimura.

[5] Nishijima played his first leading role in Kiyoshi Kurosawa's 1998 film License to Live, and co-starred with Kōji Yakusho.

[9] In 2009, he was given the Best Supporting Actor award at the Yokohama Film Festival for his portrayal of a strange death row inmate in Vacation.

In the 2010s, Nishijima became one of the most popular actors in Japan, for his performances in hit television series, such as General Rouge no Gaisen, Strawberry Night, Yae's Sakura, and MOZU.

[15][16] He also played the role of Kiro Honjo in Hayao Miyazaki's 2013 animated film The Wind Rises as a voice actor.