Andrew Hill was born on June 30, 1937, in Chicago, Illinois. Port Au Prince, Haiti, is usually given as Hill's birthplace, but he actually hails from Chicago. He studied composition privately with Paul Hindemith and Bill Russo, and played accordion and tap-danced on the streets where Earl Hines heard him. When he was in his teens he was a member of Paul Williams's R&B band, played with Charlie Parker, Coleman Hawkins, Gene Ammons, Von Freeman, Johnny Griffin, Malachi Favors, John Gilmore, and became virtually Chicago's "house" pianist for visiting artists.

Having spent some months in New York as Dinah Washington 's accompanist, he relocated there in 1960 while working with Johnny Hartman. From 1962-1963, he worked in Los Angeles with Rahsaan Roland Kirk, Jimmy Woode, among others. In 1963 he returned to New York to work with Joe Henderson. During the 60s he made a number of excellent albums for Blue Note Records (under his own name and with Bobby Hutcherson, probably the best-known being Black Fire and the highly-acclaimed Point Of Departure, which featured Henderson, Eric Dolphy and Kenny Dorham. Later Blue Note sessions (several of which remain unissued) often show a dense, turbulent music that is both strikingly individual and intensely gripping; Compulsion has John Gilmore in ferocious form, while a set recorded with Sam Rivers, (and later released under the tenorist's name as one half of the double-set Involution) has a moving, almost desperate, sombreness. When the contract ran out in 1970 Hill moved to upstate New York.

During the 70s he held a number of academic posts, including composer-in-residence at Colgate University in New York (where he wrote pieces for string quartet and orchestra) and with the Smithsonian Institute, for whom he toured rural areas of the US, playing hospitals, prisons and introducing jazz to an entirely new audience.

In 1977 he moved to Pittsburgh, California (near San Francisco), and from the early 80s his career seemed to take off again, with more record releases (most notably the 1986 recording Shades, with Clifford Jordan and tours, including a season at New York's Knitting Factory, and a Contemporary Music Network tour of Britain with Howard Riley, Joachim K’hn and Jason Rebello in 1990. Now re-signed to the new Blue Note, where he has been paired with alto saxophonist Greg Osby, Hill is a highly individual pianist and composer who is often compared to Thelonious Monk and Cecil Taylor, if only by virtue of his uniqueness. This quality has persisted through the brooding power of his 60s music to the more celebratory feel of recent releases. When asked to describe his musical style Hill remarked:

"I'd say interesting . . . happy . . . warm....There was an angry period, but you get tired of pounding the piano. It's too good an instrument."