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Old Hill was historically in the urban district and later county borough of Rowley Regis, and in the county of Staffordshire. However, local government reorganisation in 1966 saw it become part of the new County Borough of Warley, and transferred into the county of Worcestershire. This arrangement lasted until 1974, since when it has been part of the borough of Sandwell and the county of the West Midlands. The town centre was by-passed with the construction of a new single-carriageway road (Heathfield Way) in 1991, relieving the town centre of some of its heavy congestion.
Old Hill High Street is home to several takeaways, ladies clothes shop, pet food shop, former butchers, KFC (opened in 2005 on the site of a former public house) and six different churches. Old Hill has undergone redevelopment. Old Hill Police station stands on the Halesowen Road.
The Eliza Tinsley factory was sold off in 2005 due to the firm's financial difficulties and has now become a housing estate.
In the 1940s and 1950s the High Street was very different and contained some desirable shops typical of many main streets in the Black Country at that time. Thomas' Butchers and slaughterhouse was next door to the Grand. It was a family business as most shops were and old Mrs Thomas worked tirelessly well into retirement age. Needhams was a small family grocers and was spotlessly clean. Old Guys sweetshop and tobacconist was a joy to visit. Old Mr Guy was a tiny man who stocked all the best sweets and sold ice cream cornets with chocolate sprinkles. The greengrocers on The Cross was called 'Timmies' and was completely open at the front like a market rather than a shop.
The Cook Shop is the longest serving business in Old Hill and in 2010 celebrated its 120th anniversary under the ownership of the same family.
Old Hill's market hall closed down in 2006. In December 2010 it reopened as a Costcutter store.
The old Plaza bingo hall, formerly a theatre, has been redeveloped and reopened April 2010. The building now called the Plaza was originally The Grand, a cinema, and then became the Plaza, a dance hall where many stars of the day performed including The Beatles, Joe Brown and Lulu. When it first opened only soft drinks and snacks were available at the 'bar'.
The Waterfall Pub on Waterfall Lane  is regularly included in CAMRA's Good Beer Guide.
Old Hill is home of the Old Hill Cricket Club.
Haden Hill Leisure Centre offers a range of sporting facilities including a gym, swimming pools and squash courts. 
In 1945 prefabs were built to house young families. They were in Cherry Orchard and Spring Meadow. Although they were meant to be temporary housing they were much loved family homes for twenty years or more.To most of the people who moved into them they were the ultimate luxury with big rooms, large windows, indoor toilet and a bathroom. Kitchens with built-in cookers and fridge a real luxury for people moving from tiny terraced houses with the privy in the back yard and only the brewhouse to do the washing and get hot water. They all had gardens big enough for flowers and vegetables and plenty of room to play.
The Riddins Mound council estate was built near the Halesowen Road railway overbridge in the 1960s, consisting of 547 homes across three tower blocks, seven three-storey blocks of flats, nine maisonette blocks and four bungalows. However, the estate had fallen into decline by the early 1990s, and in August 1996 one of the tower blocks was demolished in a controlled explosion while the remained properties were refurbished and community facilities improved.
Haden Hill House, a Victorian gentleman's residence set in a park is situated to the south of the town centre. The house and park are owned by Sandwell Borough Council and are open to the public. Haden Hall, a building dating from the Tudor period is next to Haden Hill House.
Schools and Education
Ormiston Forge Academy, (formerly Heathfield Foundation Technology College, and previously Heathfield High School) which was built during the 1970s, is located on Wright's Lane is the only secondary school in Old Hill and Cradley Heath. By 1988 the school built a new technology block and a sports hall. Temple Meadow Primary School and Nursery is also on Wright's Lane, whilst Redall Hill Primary School can be found on Trinity Street, in the buildings of the former Macefields secondary School
Old Hill is served by Old Hill railway station on the main line from Birmingham, Snow Hill, to Stourbridge.
A branch of the Dudley Canal runs to the east of the town.
It is the birthplace of cricketer Eric Hollies and his father Billy Hollies, one of the last of the underarm bowlers in League cricket. At present the most famous person from the town is comedian/comic actress Josie Lawrence who has been the star of Whose Line Is It Anyway?, EastEnders and has topped the bill in London's WestEnd.
The Parish Church is Holy Trinity, situated at the junction of Lawrence Lane and Halesowen Road (the main street).
Our Lady of Lourdes serves the Roman Catholic community.
The Methodists now meet at a building on the corner of Lawrence Lane and Clyde Street, built after several other congregations amalgamated. There is also a Wesleyan Reform Union church, St James', relocated to Highgate Street (opposite Willetts Way) to make way for Cradley Heath bypass.
There are two Strict Baptist chapels, Spring Meadow and Station Road.
There is an independent mission church, the Macefield Mission, in Claremont Street.
- The Waterfall
- Haden Hill Leisure Centre
- "Tower block is demolished in Old Hill; Freeze frame August 19, 1996. - Free Online Library". Thefreelibrary.com. Retrieved 2012-03-06.