Livingston first appeared as Emily Quartermaine on General Hospital on April 1, 2003. The adopted daughter of established characters Alan and Monica Quartermaine, Emily was a prominent character who notably battled breast cancer in 2003. On May 20, 2005, Livingston won the Daytime Emmy Award for Outstanding Supporting Actress in a Drama Series for her portrayal of Emily. Livingston eventually decided to leave the series, and Emily was murdered in November 2007; however, Livingston continued to appear periodically until May 7, 2008 as a hallucination of Emily seen by her love interest, Nikolas Cassadine (Tyler Christopher).

On January 15, 2009, Livingston returned to General Hospital for 11 months as new character Rebecca Shaw.

Livingston also appeared in the films Big Fat Liar (2002), Hired Help (2004), Popstar (2005) , and West of Brooklyn (2008), as well as upcoming 2009 films Fight or Flight and Rough Hustle.

Livingston is set to play Taylor Raines, Nicole's sister, on Days of Our Lives.