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In May 2019, Cairney signed a new long-term contract with Fulham. During his four-year spell at the club, he has scored 28 goals during 160 appearances.

In April 2018, he was nominated for the EFL Championship Player of the Season award. On 26 May, he scored the only goal against Aston Villa at Wembley Stadium, in the 2018 Championship play-off Final to promote Fulham to the Premier League.

At the start of the 2016–17 season, Cairney was given an armband to replace Scott Parker against Newcastle United in the opening game of the season, who didn't start, and set up a goal for Matt Smith in a 1–0 win. He then scored two goals in the first month of the league season against Leeds United and Blackburn Rovers. Both of these matches resulted him earning Man of the Match. In addition, he was nominated for the both August's Sky Bet Championship Player of the Month and August's Sky Bet Championship Goal of the Month. Despite suffering from an injury that saw him missed one match in mid–October, For the most of the season, Cairney captained the side. After scoring three more goals by the end of the year, his performance at Fulham attracted attention from Premier League side Middlesbrough, Aston Villa and Newcastle United. However, the club made it clear that Cairney was not for sale. Having kept him throughout the January transfer window, he scored two goals throughout February against Nottingham Forest and Bristol City, resulting him being nominated for February's Player of the Month. After scoring against Leeds United for the second time this season, Cairney scored the opening goal with a "thunderbolt from distance", in a 3–1 win over Newcastle United on 11 March 2017. By May, Cairney added three goals, including scoring two goals in two matches against Huddersfield Town and Brentford. He also scored in the first leg of the promotion play–offs, in a 1–1 draw against Reading, but Fulham lost 1–0 in the next leg, dashing its hopes of playing in the Premier League next season During the 2016–17 season, Cairney scored 13 times in 51 appearances in all competitions, becoming joint top–scorer, alongside Stefan Johansen. Having played a key role for the side this season, Cairney was named the club's Player of the Season, the EFL Player of the Year at the 2017 London Football Awards and was included in the EFL Championship PFA Team of the Year, alongside Ryan Sessegnon.

Ahead of the 2017–18 season, Cairney signed a one-year contract extension with the club, keeping him until 2021. He was named the new captain for the new season, succeeding Scott Parker. After playing in the season opener, a 1–1 draw against Norwich City, Cairney suffered an injury ahead of the friendly match against Reading. It wasn't the first time he suffered an injury, which occurred during the pre–season friendly. After missing two matches, Cairney returned to the first team, in a 1–0 loss against Sheffield Wednesday on 19 August 2017. In January 2018, Fulham rejected offers of £15 million and £18 million from West Ham United for Cairney.

Cairney earned his first call up from Scotland national team in March 2017. Following his first call up from the senior side, Cairney said he wanted to establish himself in the Scotland national team. He made his full international debut in a 1–1 draw with Canada in a friendly.

Cairney signed for Fulham on 26 June 2015 for an undisclosed fee, signing a four-year contract. The move for Cairney reportedly cost £3 million. Cairney was given the number 10 shirt for the new season, succeeding Bryan Ruiz, who departed the club in the summer transfer window.

Cairney made his Fulham debut, where he started and played the whole game, in a 1–1 draw against Cardiff City. In a follow up match on 15 August 2015, he scored his first goal for the club in a 2–1 defeat at home to Brighton & Hove Albion on 15 August 2015 and then scored again in a 2–1 loss against Hull City four days later on 19 August 2015. Despite the defeat, he was named the club's Man of the Match. His goal against Brighton & Hove Albion earned him August's Goal of the Month. He then scored again on 19 September 2015, in a 3–2 loss against Sheffield Wednesday. However, in a 3–0 loss against Wolverhampton Wanderers on 29 September 2015, Cairney was sent–off for "a two-footed tackle" on Adam le Fondre in the 35th minutes. After serving a three match suspension, he regained his first team place since returning and played the most of the season in the right-hand side of midfield. Cairney then ended his four months goal drought when he scored and set up a goal, in a 3–1 win over rivals, Queens Park Rangers on 13 February 2016. Following the match, he named Man of the Match. After scoring three more goals, including a brace with a 3–0 win over Charlton Athletic on 20 February 2016, his performance throughout February earned him a Championship Player of the Month. On the last game of the season, Cairney scored the only goal in the game, with a 1–0 win over Bolton Wanderers. Despite being sidelined on two occasions later in the season, Cairney scored 8 times in the total of 42 appearances in all competitions. In his first season at the club, he finished second place for the club's Player of the Season, behind Ross McCormack. During the season, he became a subject chant from Fulham supporters: 'Ain't nobody like Tom Cairney'.

He made his debut in a 1–1 draw against Derby County, as a 77th-minute substitute for Alex Marrow. Two days later, Cairney made his full debut for the club in an eventful League Cup clash with Carlisle United, scoring one and providing one assist, before being sent off for the first time in his career after two bookable offences. Cairney equalised for Blackburn in a 5–2 victory over Barnsley on 24 August, opening his Championship account for the club. Since joining Blackburn Rovers, Cairney established himself in the first team there, having quickly made an impact. He then set up two goals on 1 January 2014, in a 2–1 win over Leeds United. The next day, on 2 January 2014, his move to Blackburn was made permanent after a successful first half of the season on loan. Cairney said: "I'm very pleased to sign permanently – that was a goal of mine when I came on loan in August." After completing this permanent deal, Cairney scored his second league for Blackburn Rovers, both of them coming against Barnsley on 28 January 2014. The local newspaper Lancashire Telegraph named him as the top performer for January. However, after being sidelined with ankle injury, which he sustained against Reading, he scored on his return from ankle injury against Brighton & Hove Albion on 1 April 2014, as well as, assisting a goal, in a 3–3 draw. Despite suffering from another injury, Cairney returned to the first team, scoring two more goals against Charlton Athletic and Wigan Athletic. Cairney rounded off his successful season when fans voted him Player of the Year 2013–14. At the end of the 2013–14 season, Cairney scored 6 times in total of 40 appearances.

In the 2014–15 season, Cairney started the season well when he scored two goals by the end of the first month of the season against Cardiff City and Norwich City (for this, he won the club's Goal of the Season). He continued to play in the central–midfield role for the side and for that, he was nominated for August's Player of the Month, but lost out to Charlton's Igor Vetokele. However, in a 2–1 win over Leeds United on 22 November 2014, Cairney was sent–off for a second bookable. Shortly after serving his suspension, he then suffered ankle injury. It was not until on 26 December 2014 when he returned from the first team, where he played 69 minutes, in a 2–1 loss against Bolton Wanderers. Following his return to the first team, Cairney regained his place for the rest of the season, but struggled to score goals, as he acknowledged his second season at the club had become difficult. It wasn't until on 4 April 2015 when he scored his third goal of the season, in a 3–3 draw against Leeds United, ending his 8 months goal without scoring. Despite being sidelined on 3 occasions in the 2014–15 season, Cairney scored 3 times in the total of 45 appearance this season. During his time at Blackburn Rovers, he was the fan favourite among the club's supporters.

Cairney was born and raised in Nottingham, Nottinghamshire, to a Scottish father, who worked as a miner and then as a taxi driver. He also revealed that his father would take him to Scotland and watch Celtic as a youngster. When he was about 15 or 16, he worked for Barclays Bank for work experience. He described this as the "worst two weeks of [his] life!" and had to work 9–5 in a bank and wear suit and tie for two weeks.

Cairney was released from the Leeds United youth system at the age of 16 after being told he was too small. He had been with the club since the age of seven. Reflecting on his time at Leeds United, he said: "To be honest it crushed me, it crushed me a lot, I was with Leeds from I was seven to 16 so it was a big part of my life. I was going there three-four times a week, missing days of schools, and obviously my mum and dad had put a lot into it too. So getting released at 16, it just felt like, 'oh no, after all that effort'. But I was determined I would not stop there. I went to Hull and they offered me a YTS as they obviously saw something. And from 16–18 I shot up in height and then it went back to my footballing ability. From getting released at 16 to making my Premier League debut – if you wrote it down you wouldn't believe it. I owe a lot to (then Hull manager) Phil Brown as he believed in me. I think the academy staff at Leeds must have got a bit of a shock when they saw me playing in the Premier League! I don't know what happened to them but I think they may have got a telling off!"

On 1 August 2013, Cairney joined Blackburn Rovers on loan until January.

At the start of the 2012–13 season, Cairney played the vital role, in a 3–2 loss against Doncaster Rovers in the second round of the League Cup on 28 August 2012, when he set up two Hull City's goals in the match. However, during the match, he sustained a serious knee injury, following a reckless tackle by Doncaster's James Husband in a League Cup tie. Steve Bruce later described the challenge as a "horror tackle". After over three months out injured, Cairney returned to fitness on 8 December 2012, appearing on the bench for Hull's away victory over Watford. Cairney made his return the following week at home to Huddersfield coming on as a 63rd-minute substitute for teammate Corry Evans. In the third round of the FA Cup against Leyton Orient on 5 January 2013, he set up a goal for Nick Proschwitz, in a 1–1 draw to lead to a third round replay. In the third round replay, he scored a winning goal, in a 2–1 win to send them through to the next round. Although he appeared less and remained on the substitute bench for the rest of the season, Cairney went on to make a total of 14 appearances and scoring once for the side, as Hull City were promoted to the Premier League.

In the 2011–12 season, Cairney continued to feature in the first team and then set up a double assists, in a 3–2 win over Watford on 22 October 2011. He then scored his first goal of the season on 7 January 2012, in a 3–1 win over Ipswich Town in the third round of the FA Cup. Despite suffering a foot injury, Cairney made a total of 29 appearances for Hull in the 2011–12 season.

Following Hull's relegation, Cairney began to establish himself in the first team in the 2010–11 season. He scored one goal, a curling free kick against Norwich City that helped Hull to their first away victory in 30 games. In January 2011, he signed a contract extension with the club, keeping him until 2013. Despite suffering an injury, Cairney made the total of 23 appearances during the 2010–11 season.

Then, on 11 August 2010, Cairney was called up by Scotland under-21 side for the first time He made his debut for the against Sweden on 11 August 2010. Cairney then scored his first Scotland U21 goal on 10 August 2011, in a 3–1 win over Norway. He made a total of six appearances for the Scotland under-21s between August 2010 and February 2012.

He played for Hull against Tottenham Hotspur in the final of the pre-season Premier League Asia Trophy in Beijing on 31 July 2009. His first-team debut came against Southend United in the League Cup on 25 August 2009, when he opened the scoring with a curling long-range effort as Hull won 3–1. He went on to make his Premier League debut on 30 January 2010 in a 2–2 draw against Wolverhampton Wanderers. On 7 March 2010, Cairney scored his first league goal for Hull in a 5–1 defeat against Everton, an impressive volley from outside the area. Cairney signed a new three-year contract with the club on 31 March 2010. Having been given a first team opportunity later in the season, he made the total of 14 appearance and scoring once for the side.

Cairney was called up by Scotland national under-19 team for the first time in September 2009. He made his Scotland U19 debut, where he started and played for 50 minutes before being substituted, in a 3–1 loss against Iceland U19 on 9 September 2009. For the Scotland U19 side, Cairney went on to play two times.

Hull City gave Cairney a chance when they signed him to a youth contract in 2007. Cairney was named as Hull's Young Player of the Year for the 2008–09 season. For this, he signed a two-year contract with the club in June 2009.

Thomas Cairney (born 20 January 1991) is a professional footballer who plays as a midfielder for Championship club Fulham and the Scotland national team. Cairney has previously played for Hull City and Blackburn Rovers. Born in England, he made his full international debut for Scotland in March 2017. Cairney had previously represented Scotland at under-19 and under-21 levels.