Born at Shepton Mallet, Somerset, on 10 December 1866, the fourth child and second son of Henry William Tilley, who farmed his own land, and Emily Steeds Ford, his wife. He was educated at Queen's College, Taunton, and University College Hospital Medical School, where he obtained an entrance exhibition and was Filliter exhibitioner and Achison scholar, and played in the Hospital Rugby XV. He was also an exhibitioner in zoology and comparative anatomy at University College, London. He set up in general practice at 6 College Crescent, South Hampstead, NW, but being particularly drawn to the study of otology and laryngology he received an appointment on the staff of the old Throat and Ear Hospital in Great Portland Street, later becoming surgeon to the Throat Hospital in Golden Square. He was subsequently the first specialist to be appointed surgeon in charge of the ear, nose, and throat department of University College Hospital. This department was amalgamated, largely through Tilley's efforts, with the Royal Ear Hospital in a building, specially designed for it, presented by Geoffrey Duveen. Tilley became consulting aural surgeon to the Hospital on his retirement. He was also consulting aural surgeon to the Ministry of Pensions, and laryngologist to the Radium Institute. He practised at 72 Harley Street. Tilley was much concerned with the improvement of medical education, believing in the need for a sound general training before specialization. He examined for branch 4 (otology, laryngology, and rhinology) of the MS degree of London University, having been instrumental with Arthur Cheatle in the establishment of this branch of the examination. He also examined in 1923 for the diploma in laryngology and otology of the Royal Colleges of Physicians and Surgeons. In 1932 he was elected a Fellow of University College. He was for many years the principal referee for appointment to the Sir Felix Semon lectureship in laryngology in the University of London, and himself delivered the Semon lecture in 1934. He was president of the section of laryngology at the annual meeting of the British Medical Association in London in 1910. In 1919 he was president of the sections of both laryngology and otology, a rare combination of offices, at the Royal Society of Medicine, and in 1931-32 he was president of the Medical Society of London. He was also a Fellow of the American Academy of Ophthalmology and Otolaryngology. Tilley's own work centred chiefly in the study of the paranasal sinuses, and he had a profound knowledge of laryngeal cancer. He advocated endoscopy of the air-passages and oesophagus. He travelled much and knew his fellow-workers on the continent. He was a man of generous and kindly nature and an excellent colleague. His surgical skill was much in demand by his fellow laryngologists. Tilley married on 30 August 1894 Florence Mitchell Morris, who came as he did from Somerset, but there were no children. Mrs Tilley's health failed some years before his death, but she survived him for eight years, dying on 14 April 1949. He died at Garden Reach, St George's Hill, Weybridge on 6 January 1941, aged 74. Tilley bequeathed £800 to the Royal Ear Hospital for the Herbert Tilley museum, with £200 for an annual lecture, and all his instruments, books, etc; £1,000 to the Royal Medical Benevolent Fund; and £250 to the Research Defence Society. Publications: *Purulent nasal discharges*. London, 1901. *Diseases of the nose and throat*, 3rd and 4th editions of the text-book by R de Havilland Hall. London, 1908 and 1919. Chronic pyogenic inflammation of the antrum and other accessory sinuses, Semon lecture 1934. *J Laryng* 1935, 50, 1-26. Epidemic streptococcus laryngitis. *Brit med J* 1935, 2, 3.