Hill began driving full-time for the Ferrari Formula One team in 1959, earning three podium finishes and fourth place in the Driver's Championship. In 1960 he won the Italian Grand Prix at Monza, the first Grand Prix win for an American driver in nearly forty years, since Jimmy Murphy won the 1921 French Grand Prix. The following season, Hill won the Belgian Grand Prix and with two races left trailed only his Ferrari teammate Wolfgang von Trips in the season standings. Tragically, a crash during the Italian Grand Prix killed von Trips and fifteen spectators. Hill won the race and clinched the championship but the triumph was bittersweet. Ferrari's decision not to travel to America for the season's final round deprived Hill of the opportunity to participate in his home race at Watkins Glen as the newly-crowned World Champion.
After leaving Ferrari at the end of 1962 in the great walkout of engineers, he and fellow driver Giancarlo Baghetti started for their new team ATS. Hill continued in Formula One for a few more years until he switched to sports car racing with Ford Motor Company and the Chaparral Cars of Jim Hall. Phil Hill has the distinction of having won the first and last races of his driving career, the final victory driving for Chaparral in the BOAC 500 at Brands Hatch in England in 1967.
Following his retirement, Hill built up an award winning classic car restoration business in the 1970s called Hill & Vaughn with business partner Ken Vaughn, until they sold the partnership to Jordanian Raja Gargour. Hill had a long and distinguished association with Road & Track magazine. He wrote several articles for them, including road tests and retrospective articles on historic cars and races.
After traveling to the Monterey Historic Automobile Races in August 2008, Hill was taken to a hospital, where he died after a short illness from complications of Parkinson's Disease in Salinas, California on August 28th 2008.