In 1999, Tilson returned to Southend United as Director of the club's new centre of excellence, the establishment of which was made possible by a grant of £276,000 from the English Sports Council.

[3] The post, which enabled him to continue his playing career with Canvey Island, saw him responsible for overseeing and developing all of the centre's teams, raging from the under-9 to 16.

[4] In May 2002, he drew time on his five-year career with Canvey Island to join Newman's backroom team on a full-time basis becoming joint assistant manager with Blues' former striker David Crown.

On 3 January 2009, Tilson led Southend to a 1–1 FA Cup third round draw away at Chelsea, with Peter Clarke scoring a very late birthday equaliser.

On 28 October 2009, following the club being threatened with administration and on-loan midfielder Lee Sawyer returning to Chelsea, Tilson came out of retirement to play for Southend in the Essex Senior Cup.

[8] On 4 July 2010, Steve Tilson was placed on gardening leave by Southend United, bringing an end to his seven-year reign as manager.

[15] On 3 July 2021, Tilson was named as assistant manager to Julian Dicks at Heybridge Swifts, following Karl Duguid leaving the club.