In 2003, Elliott and his twin brother Luke had a brief appearance in Brookside as Terry Gibson’s twin sons.
Subsequently Elliott and his brother Luke were cast the shared role of Carl Gallagher in comedy drama Shameless. Elliott took over the role entirely when Luke left the show to become a regular on soap drama Emmerdale. He has since appeared in every season broadcast.
In addition to his role in Shameless, Elliott has appeared in an episode of BBC One drama miniseries Moving On, entitled Butterfly Effect. He has also appeared in episodes of Silent Witness and starred in short film Protect Me From What I Want, playing a gay character.
In January 2010, Tittensor appeared on the cover of Attitude magazine. He also appeared in the video for Plan B’s Stay Too Long, alongside his partner, actress Kaya Scodelario.