Needham made his professional debut in BBC medical drama Casualty, as Junior doctor Toby De Silva making his first appearance in September 2007.
In 2011, he appeared in the ITV medical drama, Monroe as David Foster, a patient with a blood clot.
[7] In 2015, Needham starred in the short film Stutterer, written and directed by Benjamin Cleary and produced by Serena Armitage and Shan Christopher Ogilvie.
In March 2017, he played Stanley Kowalski in the BBC Radio 3 production of A Streetcar Named Desire by Tennessee Williams.
In 2021, he starred as the lead in the Independent film, Knightman, written and directed by Jun Sekiya.