His maternal grandparents were the Hungarian-born British Jewish filmmaker Emeric Pressburger and English screenwriter and actress Wendy Orme.

Macdonald began his career with a biography of his grandfather, The Life and Death of a Screenwriter (1994), which he turned into the documentary The Making of an Englishman (1995).

After making a series of biographical documentaries, Macdonald directed One Day in September (1999), about the murder of Israeli athletes at the 1972 Munich Olympics.

His next film was Touching the Void, a docudrama that told the story of two climbers making the first successful ascent of the West Face of Siula Grande, a major peak in the Peruvian Andes, in 1985 and the subsequent dramatic series of events during their descent after one of the climbers broke his leg whilst high on the peak.

Macdonald directed the film adaptation of hit BBC television drama State of Play, starring Russell Crowe.

The film received mixed to positive reviews, with critics praising Macdonald's direction, its cinematography and performances of the cast but criticised its screenplay.

His 2023 project George Blake, produced by Femke Wolting, won the development prize at 2024 Series Mania SERIESMAKERS section.