Bilbo overcame accusations of accepting bribes and won election as lieutenant governor, a position he held from 1912 to 1916.
In 1915, he was elected governor, and he served from 1916 to 1920.
The negro has confessed, says he is ready to die, and nobody can keep the inevitable from happening.”’ The state constitution prohibited governors from having successive terms. Afterward, Bilbo caused controversy by hiding in a barn to avoid a subpoena in a case involving his friend, then-governor Lee M. He had served as Bilbo's lieutenant governor, and was being sued by his former secretary, who accused Russell of breach of promise and of seducing and impregnating her.
She had undergone an abortion that left her unable to have children.
Cresswell (2006) argues that in his first term (1916–20) Bilbo had "the most successful administration" of all the governors who served between 18, putting state finances in order and supporting Progressive measures such as compulsory school attendance, a new charity hospital, and a board of bank examiners.
Bilbo was of short stature (5 ft 2 in or 1.57 m); he frequently wore bright, flashy clothing to draw attention to himself, and he was nicknamed "The Man" because he tended to refer to himself in the third person.
His second term was filled with controversy involving his plan to move the University of Mississippi from Oxford to Jackson. During the 1928 presidential election, Bilbo helped Al Smith to carry the state by a large margin; he spread stories that Republican Herbert Hoover had socialized with a black woman, so voters should vote against him.
In 1930, Bilbo convened a meeting of the State Board of Universities and Colleges to approve his plans to dismiss 179 faculty members.
In another controversy, he aided Democratic nominee Al Smith in the 1928 presidential election by spreading the story that Republican nominee Herbert Hoover had socialized with a black woman; Southern voters, considering whether to maintain their allegiance to the Democratic Party in light of Smith's Catholicism and support for the repeal of Prohibition largely remained with Smith after Bilbo's appeal to racism.
In 1930, under Governor Bilbo, Mississippi introduced a sales tax – the first American state to do so.
After teaching school he attained admission to the bar in 1906, and practiced in Poplarville.