O'Malley is a founding member of several groups including Sunn O))) (1998–present), Burning Witch (1995–1998), KTL (2005–present), Khanate (2000–2006). Within these groups and alone, he has collaborated with a variety of artists including Greg Anderson, Merzbow, Eyvind Kang, Alan Moore, Iancu Dumitrescu, Ana-Maria Avram, F.M. Einheit, Randall Dunn, James Plotkin, Julian Cope, Joe Preston, Attila Csihar, Stuart Dempster, Peter Rehberg aka PITA, Lee Dorrian, the Japanese psychedelic rock band Boris & Michio Kurihara, Jim O'Rourke, Daniel O'Sullivan & Kristoffer Rygg (in the free improvisation act Æthenor together with Steve Noble), Aaron Turner, Oren Ambarchi, Alexander Tucker, and percussionist Z'EV.[2]
O'Malley also produced work together with the French choreographer and theatre director Gisèle Vienne (the pieces "Kindertotenlieder" (2007), "Jerk" (2008), "Eternelle Idole" (2009), This Is How You Will Disappear (2010)),[3], Last Spring: A Prequel (2011), American sculptor Banks Violette (various projects between 2005–2009), the Italian performance artist Nico Vascellari (2007–2011), Swiss art collective KLAT (2009), and the Belgian film maker Alexis Destoop ("Kairos" (2010), with Oren Ambarchi).
O'Malley has directed and produced album cover art and design since the early 1990s for groups including Earth, Burzum, Emperor, Melvins and Boris. He has also worked as a rock/metal music journalist & published a black metal fanzine called Descent in the nineties. He was involved with creation of both the Southern Lord[4] label and the experimental/neofolk/black metal label The Ajna Offensive.[5].