Mike Alisa added a pair of touchdown runs, JD Falslev returned a punt 71 yards for a score and the Cougars (2-2) finished with 309 yards rushing and 486 yards of total offense. They held the Blue Raiders (3-2, 1-0 Conference USA) to 212 yards.
Logan Kilgore was 13 of 21 for 82 yards and a touchdown for Middle Tennessee. The Blue Raiders forced five turnovers, but could do little against the Cougars' defense.
Middle Tennessee struggled to contain Hill throughout the first half. He rushed for 142 yards and two touchdowns and threw for 96 yards on 8-of-9 passing.
The Cougars ran only eight plays in the first quarter as the Blue Raiders held the ball for nearly 12 minutes. Still, BYU led 7-3 after Adam Hine returned a kickoff 90 yards to set up Hill's 12-yard scoring run.
Middle Tennessee took a 10-7 lead after BYU had three consecutive turnovers. Falslev fumbled a punt return to give the Blue Raiders the ball deep in Cougars territory and it led to Kilgore's 16-yard TD pass to Marcus Henry with 36 seconds left in the first quarter.
Two more fumbles kept the Cougars from reaching the end zone early in the second quarter. Hill coughed up the ball on a keeper at the Middle Tennessee 2, and BYU marched down the field quickly again on its next possession, only to have Alisa fumble into the end zone.
BYU's defense kept Middle Tennessee from doing anything positive after the two fumble recoveries. The Cougars forced a safety following Hill's fumble when Kyle Van Noy brought down Jordan Parker in the end zone.
BYU finally retook the lead after forcing a Blue Raiders punt following Alisa's fumble. Hill broke loose for a 50-yard run that put the Cougars up 16-10 with 7:31 left in the second quarter. They extended it to 23-10 when Alisa punched in a 2-yard scoring run just before halftime.
Alisa added another 1-yard scoring run to cap BYU's opening drive in the second half. Falslev then closed the third quarter with the long scoring punt return to complete the scoring.
BYU receiver Cody Hoffman sat out the game after being suspended for violating a team rule. Coach Bronco Mendenhall didn't provide details in announcing the one-game suspension.
The senior, the team's receiving leader entering the game, also missed the season-opening loss to Virginia because of a hamstring injury.
He is the second high-profile player to be suspended in two weeks. Starting linebacker Spencer Hadley was suspended for five games before last week's loss to Utah after violating the school's honor code.