The Guardians recalled Pilkington from Triple-A Columbus ahead of his scheduled start in the second game of Tuesday's doubleheader with the White Sox in Cleveland.
The rookie southpaw is serving as Cleveland's 27th man for the twin bill, so he'll likely be headed back to Columbus immediately following the start. Pilkington has previously made 10 appearances and seven starts for Cleveland this season, pitching to a 4.08 ERA and 1.67 WHIP across 35.1 innings.