UK drill is a subgenre of drill music and road rap that originated in the South London district of Brixton from 2012 onwards. While being sonically distinct from Chicago drill music, it embraces its aesthetic and melds it with road rap, a British style of gangsta rap that became popular in the years prior to the existence of drill. UK drill lyrical content tends to be truculent, depicting the harsh realism of their lifestyles. The explicit lyricism has stimulated discussion about whether or not the subgenre is a factor in an increase in knife crime in London. Gang affiliation and socioeconomically-deprived backgrounds are common amongst UK drill artists. Artists such as 150, 67, Harlem Spartans, 1011, and 410 have been cited as innovators of UK drill.

UK drill developed a different production style than the most common Chicago beat patterns, albeit still based on Chicago drill styles originally pioneered by DJ L, a Chicago producer who collaborated with rapper G Herbo in the early Chicago scene. The genre also took influence from earlier British genres such as grime and UK garage; in an interview with Complex, Jammer noted that "without grime...there would be no UK drill." Drill producer Mazza noted that both drill and grime share a similar rawness and energy, despite the two genres remaining distinct from each other. Drill producer Carns Hill, alongside several drill rappers, noted that UK drill should probably have a "new name" to distinguish it from the original Chicago drill sound. UK drill is generally more fast-paced compared to its Chicago counterpart. UK drill beats are generally structured around an contrast to the typical trap/Chicago drill beat, the hi-hats have moved from on-beat and triplet subdivisions to a steady 3+3+2 polyrhythm, hi-hat pattern, with snares landing on the fourth beat instead of the third every 2 bars. Instrumentals often also have a sliding bass, hard hitting kicks, and dark melodies. AXL Beats explained that the 808s and fast-tempo snares in UK drill are derivative of grime music. Both genres typically use a tempo of approximately 138–151 beats per minute. The use of British slang, intricate lyrical flows, and elements of social commentary further help distinguish UK drill from its Chicago and Brooklyn counterparts, which are often characterised by a more aggressive, stream-of-consciousness style. As referenced in the book What Do You Call It? From Grassroots to the Golden Era of UK Rap (2024), UK drill also developed its own distinct visual identity, shaped in part by economic realities. As Brixton-based rapper Skengdo explained: "The Chicago lot had True Religion jeans, Timberlands, they were all swagger. But coming up as 15–16-year-olds in the ends, not everyone can afford expensive brands. So [we're wearing] Nike tracksuits and Tech hoodies in the video."

Censorship of UK drill lyrics through vocal cuts and mutes is sometimes done to avoid them being used during their prosecution by the police; for example, "shh" is used in songs to replace the names of people, weapons and criminal acts.

150 (now known as GBG), a group from the Angell Town Estate in Brixton, is often credited with pioneering UK drill music, with 150 members Stickz, M Dargg and Grizzy (stylized as GR1ZZY) being dedicated exponents of the early style. 67 is often credited for shifting the sound away from the Chicago influences it seemed to heavily draw inspiration from in its early days and foundation and for forming a more homegrown sound. Producers Carns Hill (who crafted instrumentals for many of 67's early songs) and QUIETPVCK (who worked closely by 150 and 410 members in their early era) are widely considered to be two of the main pioneering producers of the genre with their unique and innovative alternatives to the Chicago drill sound.

An article from VICE divided the history of UK drill into 3 phases; the first of these phases, which lasted from 2014 to 2018, resulted in drill becoming "its own distinctly British entity", with the phase peaking in 2016 following the release of "Let's Lurk" by 67, featuring Giggs. Given that the genre was "locked out" of the mainstream music industry due to its uncensored nature, music videos became a major player in the genre's circulation. Its uncensored nature also resulted in Form 696 being used to cancel shows by drill artists. In early 2017, "Kennington Where It Started" was released by the Harlem Spartans, considered by fans to have turned UK drill from an underground genre into a mainstream one.

In 2018, members of 1011 (now known as CGM), including Digga D, were given a court order that banned them from making music without police permission; in addition, they couldn't mention death or injury, including the death of Abdullahi Tarabi, and had to notify police in advance of any song releases or performances. Kevin Southworth, Detective Chief Superintendent, noted that it was "one of the first times" that such an order was made. The order was condemned by Index on Censorship.

In 2019, Skengdo & AM, members of drill group 410, were handed a 9-month suspended sentence, suspended for 2 years, for breaching a gang injunction. According to The Guardian, the injunction, which lasted until January 2021, prevented Skengdo & AM, as well as 2 other members of 410, from entering the SE11 postcode, as well as prohibiting them from performing songs that had lyrics mentioning rival crews, their rappers or any mentions to them entering the territory of other groups. The sentence resulted in a letter being signed by 65 people that was addressed to the Metropolitan Police, calling upon them to stop issuing gang injunctions and stating that musicians should be given the rights of freedom of speech and creative expression.

In March 2025 Eddy Frankel, reviewing in The Guardian the art installation on drill music Anti-Blackness Is Bad, Even the Parts That We Like by RIP Germain, said that the UK drill scene was dead as so many singers were in prison—the installation depicted 42 rappers, all in prison.