Monger began karting at age six after his father, himself a former kart racer, bought him his first go-kart. He competed in kart racing across the UK and the Channel Islands and also raced in the Ginetta Junior Championship before moving into single-seaters.
In 2016 Monger joined JHR Developments for the F4 British Championship, taking three podiums and finishing 12th in the championship. He remained with the team for the 2017 season.
On 16 April 2017, during a race at Donington Park, Monger crashed at high speed into the back of Finnish driver Patrik Pasma. Both of Monger's legs were amputated as a result: his left leg above the knee, leaving a short thigh stump, and his right leg below the knee. Pasma was not seriously injured. Monger was conscious after the crash.
JHR Developments set up a JustGiving page that raised over £500,000 within the first 24 hours. Donors included Jenson Button, Lewis Hamilton, Max Verstappen, Daniel Ricciardo, Jolyon Palmer, and Nico Hülkenberg.
In June 2017 Monger announced he would return to competition in November, sharing a Group CN Ligier JS53 Evo 2-Honda with quadruple amputee Frédéric Sausset at a round of the V de V Challenge Endurance Proto at the Autódromo do Estoril in Portugal. The programme had the eventual aim of fielding a team of three disabled drivers at the 2020 Le Mans 24 Hours. In July 2017, Monger tested a Fun Cup race car adapted with hand controls by disabled motorsport specialists Team BRIT at Brands Hatch, where he regained his race licence.
In February 2018 Monger tested a BRDC British Formula 3 car for Carlin at Oulton Park — his first single-seater outing since the crash. To race in F3, he and his family appealed to the FIA to change regulations that had restricted disabled drivers from racing single-seaters on safety grounds. The FIA lifted the ban in December 2017, permitting disabled drivers to race modified single-seaters provided they passed safety checks. Modifications to Monger's car included repositioning the brake pedal so he could brake using a leg stump and replacing the throttle pedal with a steering-wheel-mounted lever. He finished third in the opening BRDC British Formula 3 meeting at Oulton Park.
In June 2018 Monger drove a Formula 1 car for the first time, testing a Sauber C30 at Rockingham Motor Speedway in Corby. The car was converted to match the hand controls from his Carlin F3 car.
In 2019 Monger competed for Carlin in the Euroformula Open championship and achieved his first single-seater race win at the Pau Grand Prix.
From 2019 Monger provided analysis for Channel 4 F1 and co-commentary for W Series. He also contributed to Channel 4's Paralympic Games coverage and the Parasport presenting team. A documentary about his first F1 drive aired as part of Sky F1's coverage of the 2018 Austrian Grand Prix. A BBC documentary, Driven: The Billy Monger Story, was released on BBC Three in November 2018. Monger was confirmed to present his own slot Breakfast with Billy and the opening and closing ceremonies for the 2026 Paralympics on Channel 4.
Monger was awarded the BBC Sports Personality of the Year Helen Rollason Award in 2018 for outstanding achievement in the face of adversity.
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