Merryton, Lanarkshire born inside right Tommy Cairns played in Scottish junior football for Burnbank Athletic in 1910 and Larkhall Thistle in 1911 where he was spotted and signed by Bristol City in the 1911 close season, for whom he made his Football League debut against Fulham that September. After 11 games and a single goal he returned north of the border in 1912 joining Peebles Rovers, and after a brief spell at St Johnstone in 1913 he joined Glasgow Rangers in November 1913 making his debut the next month against Hamilton Academical, with whom he would go on loan in 1918.
Cairns became a regular in the Rangers team the following season and in 1918 was a member of the Rangers team that won The Scottish League for the first time in five seasons, scoring 11 goals. He would go on to win a further 6 Scottish League titles over the next nine seasons, playing his last game for Rangers in March 1927 before joining Bradford City in the summer, having scored 144 goals in 441 appearances for The Gers.
While at Rangers he was first capped for Scotland in February 1920, scoring in a 1-1 draw against Wales at Ninian Park, and won a total of 8 caps over the next four years, never appearing on a losing side. He also represented The Scottish League six times between March 1922 and March 1926. At Bradford City he played a further five years. A near ever present in his first season, he missed only four games as The Bantams won the Third Division (North) Championship in 1929. Cairns 146 matches, scoring 36 times, before retirement in 1932. He later worked as a scout for Arsenal.