Pilkington gained prominence as the producer of Ricky Gervais and Stephen Merchant's radio programme on Xfm. He appeared on "The Ricky Gervais Show", presented the Sky travel comedy series "An Idiot Abroad" and made his full acting debut (following a cameo appearance in the final episode of "Extras") on Gervais's 2012 comedy–drama series "Derek". Pilkington is a co-founder, along with Gervais and Merchant, of RiSK Productions, a television production company. Pilkington also starred in the Sky 1 travel documentary comedy series "The Moaning of Life" (2013–2015). In 2018, Pilkington starred in a new scripted comedy series, "Sick of It."