He made his acting debut on 12 April 2012 in the Channel 4 comedy-drama "Derek", portraying caretaker and bus driver Dougie. He left the show after the first episode of the second series. From 2013 to 2015, Pilkington starred in a two-series Sky 1 documentary called "The Moaning of Life". From 2018 to 2020, he co-wrote and starred in a Sky 1 scripted sitcom called "Sick of It". Pilkington has also performed voice-over work for such clients as One Stop Office Shop, FreeView, Vodafone, HMV, Sony PSP, WHSmith, Wickes and Unilever.