Originally named The Flu, the group was assembled whenever cEvin and Dwayne lived temporarily in Toronto while away from touring/recording with Skinny Puppy. They released a few cassettes in Europe, composed of material that was very much a precursor to Hilt. In 1989, Key and Goettel's label Nettwerk made a bet with the group that they could not produce and record an album for a low budget, reputedly $15,000. They accepted, and the result is the lo-fi debut Call the Ambulance (Before I Hurt Myself). An EP followed in 1991, entitled Orange Pony, with the follow-up LP Journey to the Center Of the Bowl.
During the years of 1992-1995, Key and Goettel focused on Skinny Puppy, putting Hilt on the side. After the untimely ends of both Skinny Puppy and Goettel, Key continued recording his many side projects, which included Hilt. Sessions with Al Nelson continued in 1996, with three songs recorded as a result. Al Nelson died from complications due to diabetes on January 23, 2000. Key lamented (verbatim): "Al was the nicest and most real person I have ever known. He had a sense of humour that could make anyone smile. He was incredibly talented. He was very dedicated to his friends, and his heart was beautiful. He will be greatly missed."
In 2003, Key released The Worst Of the Flu, an odds-and-ends collection of unreleased and alternate tracks by Hilt & the Flu recorded from 1985-1990. Another recording, Minoot Bowl Dropped the Ball, featuring material of a similar ilk to Worst of the Flu, was released in 2007. According to Key, approximately seven LPs worth of material were recorded in the above time period, and may see the light of day in the future.