Wilson is a self-taught producer, audio engineer, guitar and keyboard player, playing other instruments as needed, including bass guitar, autoharp, hammered dulcimer and flute. Despite being mainly associated with prog music, his influences and work have encompassed diverse genres such as psychedelia, pop, metal, electronic, and jazz, among others, shifting his musical direction through his albums. His concerts incorporate quadraphonic sound and elaborate visuals.
In a career spanning more than 30 years, Wilson has made music prolifically and earned critical acclaim. His honours include four nominations for the Grammy Awards, twice with Porcupine Tree, once with his collaborative band Storm Corrosion and once as a solo artist. Nevertheless, his work has largely stayed away from mainstream music, being described by publications such as The Daily Telegraph as "the most successful British artist you’ve never heard of."