The Red Sox re-signed Hill to a minor league contract with an invitation to spring training on December 16, 2010. Hill transitioned to a "sidewinder" pitcher during spring training and out performed other relievers trying to make the roster but was optioned back to Pawtucket to start the season. He appeared in 10 games in the minors, pitching 16 innings and had a 1.12 ERA with one save. His contract was purchased by the Red Sox and he was called up to the majors on May 5.