Malcolm Bilson has been in the forefront of the period instrument movement since the early 1970s. His performances of Haydn, Mozart and Beethoven and Schubert on late 18th and early 19th century pianos have been a key contributor to the restoration of the fortepiano to the concert stage and to recordings of the "mainstream" repertory. He has brought fresh insights to the interpretation of the piano works of those masters in solo, chamber music and concertos.

He has recorded the three most important complete cycles of works for piano by Mozart: the Piano Concertos with John Eliot Gardiner and the English Baroque Soloists for Deutsche Grammophon/Archiv, the solo Pianos Sonatas for Hungaroton and the Piano-Violin Sonatas with Sergiu Luca for Nonesuch, along with numerous other solo and chamber music disks for various labels. He has also toured extensively with the English Baroque Soloists with John Eliot Gardiner, the Academy of Ancient Music with Christopher Hogwood, the Philharmonia Baroque under Nicholas McGegan, Tafelmusik of Toronto and Concerto Koln in addition to other early and modern instrument orchestras around the world.

Since the mid-1980s Bilson has been focusing his attention increasingly on the piano literature of the 19th century. With the Orchestre Revolutionnaire et Romantique he has toured with the Schumann Piano Concerto; with the Monteverdi Choir (also under John Eliot Gardiner) he has presented Schubert in London. Works of Beethoven, Schubert, Schumann, Mendelssohn and Brahms figure prominently in his most recent European and US tours. The Piano-Cello Sonatas of Beethoven with Anner Bylsma are on the Nonesuch label, and his traversal of the Schubert Piano sonatas on period pianos for Hungaroton (including the so-called incomplete sonatas) is nearly finished. For Deutsche Grammophon a disc of Schubert's four-hand music with Robert Levin appeared in November, 1997.

Bilson teaches and lectures extensively around the world. As the Frederick J. Whiton Professor of Music at Cornell University, he directs keyboard studies in 18th Century Historical Performance Practice. He has given workshops and master classes at the University of California, at the Paris, Oberlin and Peabody Conservatories, at the Juilliard School, at the Sibelius Academy in Helsinki, at the Franz Liszt Academy in Budapest, at the Music Academies of Oslo , Stockholm, Tokyo and Hong Kong, Italy and Belgium, at the Jerusalem Music Centre and at various schools of music in New Zealand and Australia. He is Adjunct Professor at the Eastman School of Music. In 1991 he was awarded an honorary doctorate by Bard College, and is a Fellow of the American Academy of Arts and Sciences.

In the fall of 1994 Bilson and six of his former artist-pupils presented the 32 Piano Sonatas of Beethoven in New City, the first time these works had ever been given as a cycle on period instruments. The New York Times said that "what emerged in these performances was an unusually clear sense of how revolutionary these works must have sounded in their time." In 1996 the group recorded the series for the Claves label, and it has since been presented in Florence and Palermo.

Bilson continues to have a rich and varied concert career divided between solo performances, chamber music, lieder recitals and orchestra concerts. He is a frequent soloist with leading early instrument orchestras at festivals such as Mostly Mozart in New York, the Salzburg Mozartwoche and the Budapest Early Music Weeks. He often tours with cellist Anner Bylsma, recently in Berlin, Vienna and Budapest.