In 2012, Madeley wrote and starred in the
Lime Pictures TV movie
Scrims. She has had several supporting roles in television, including
Fresh Meat and
The Level. She starred as Anna in the 2015 TV movie ''Don't Take My Baby'', chronicling a disabled couple's fight to prevent their baby from being taken away, The following year, she was listed as one of BAFTA's 18 Breakthrough Brits. At the time of filming, Madeley was working in fundraising at Whizz Kidz. She returned to the job after her BAFTA win, thinking there would not be enough roles for disabled actresses for her to make a career in acting. In
Russell T Davies' 2019
BBC/
HBO miniseries,
Years and Years, Madeley played Rosie Lyons. The role of Rosie was not originally written for a wheelchair user, but after her audition, Davies decided to work with Madeley to reshape the role around her spina bifida. In 2019, Madeley signed an open letter urging Hollywood executives to normalise disability by casting disabled actors to play disabled characters. In 2020, she appeared in the Christmas special episode of
Would I Lie to You? and appeared in Mat Fraser's
CripTales, a collection of disability monologues. In 2021, she competed on
Celebrity Best Home Cook and played
Throat in the television adaptation of
Terry Pratchett's
Discworld novel,
The Watch. In 2021, she was cast in the BBC One comedy series,
The Cleaner and starred as
Barbara Lisicki in the 2022 BBC Two drama,
Then Barbara Met Alan. She also appeared in
Tom Stern and Celyn Jones' film,
The Almond and The Seahorse, inspired by
Kaite O'Reilly's play of the same name. Madeley's first theatre role was in
The Greatest Wealth at
The Old Vic in 2018.
The Greatest Wealth consisted of seven monologues and was put together in celebration of the 70th anniversary of the
NHS. Madeley's monologue, "Choice & Control" was written by
Matilda Ibini. In late 2019 and early 2020, she played Barbara 'Buck' Buckingham in
Teenage Dick at the
Donmar Warehouse directed by
Michael Longhurst. The play, written by
Mike Lew, was inspired by
Shakespeare's
Richard III. The character of Buck was based on the character of the Duke of Buckingham and was explicitly written to be played by a disabled actor. In September 2021, it was announced that she would star alongside
Colin Baker and
Bonnie Langford in the
Big Finish Doctor Who audio dramas as a new companion of the
Sixth Doctor, marine biologist Hebe Harrison. The boxset,
The Sixth Doctor Adventures: Water Worlds, was released in May 2022. She was cast as Shirley Anne Bingham in the television series'
2023 specials, which were written by Davies, who has returned as showrunner. Madeley and
Ruben Reuter appeared in a documentary from Channel 4 on disability and abortion titled
Disability and Abortion: The Hardest Choice. The documentary aired in August 2022. In September-October 2025 Madeley appeared in
Richard Osman's House of Games Series 9 Week 1 where she came 3rd having won one show. Filming took place in 2025 on a television adaptation of
The Rapture by
Liz Jensen for BBC One, starring Ruth Madeley who is also an executive producer. ==Personal life==