Macauley played in the NBA with the St. Louis Bombers, Boston Celtics, and St. Louis Hawks. Macauley was named MVP of the first NBA All-Star Game (he played in the first seven), and was named to the NBA's All-NBA First Team three consecutive seasons. He was named to the All-NBA second team once, in 1953–54—the same season he led the league in field goal percentage. Macauley's trade (with Cliff Hagan) to St. Louis brought Bill Russell to the Celtics. In the two years he coached with the Hawks, he led them to an 89–48 record, with a 9–11 playoff record. After retiring, he became sports director of KTVI, then the ABC affiliate in his native St. Louis.