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His first major onscreen appearance was in his first collaboration with filmmaker/director Shane Meadows, A Room for Romeo Brass (1999), and he then played Alfie in Paweł Pawlikowski's Last Resort (2000). Other credits include Doctor Sleep (2002), 24 Hour Party People (2002), In America (2003), My Summer of Love (2004), and Dead Man's Shoes (2004), winning the 2005 Empire Award for Best British Actor and a nomination for the BIFA for Best Actor. He wrote and directed Dog Altogether (2007), winning a BAFTA Award for Best Short Film, and its 2011 feature film adaptation Tyrannosaur which won BAFTA for Outstanding Debut by a British Writer, Director or Producer. He directed and starred in Journeyman.

On stage, Considine received Olivier Awards and Tony Award nominations as Best Actor in 2018 and 2019 for his performances in The Ferryman at the Royal Court Theatre, at the Gielgud Theatre, and at the Bernard B. Jacobs Theatre on Broadway. On television, Considine has been lead in Pu-239 (2006), My Zinc Bed (2008), Red Riding (2009), Informer (2018), and The Suspicions of Mr Whicher series of television films (2013–2014). Other television credits include Peaky Blinders (2016), The Outsider (2020), The Third Day (2020), and most notably he played a lead role as King Viserys I Targaryen in House of the Dragon (2022–2024).