The dressing room at 23 Hill Street is located on the first storey of the house, and Adam's ceiling was executed and partly survives in situ. The surviving ceiling shows some alterations when compared with Adam's drawing. It is known that the central fan was replaced with a large circular medallion in the nineteenth century, but the painted, ornamental differences may result from changes made in execution, or, indeed, alterations undertaken during the nineteenth century.

Pullins has suggested that the ceiling was also modified by James Stuart, immediately following Adam's tenure, and that the eight surviving eighteenth-century medallions in the ceiling - which depict the twelve signs of the Zodiac - were installed to designs by Stuart, and inserted into Adam's earlier plasterwork.

This arrangement, composed of a ring of eight roundels is inspired by copies after antiquity - such as within the Baths of Augustus - by Francesco Bartoli in the Topham Collection, and Bernard de Montfaucon in his Supplement au livre de l'antiquitée expliquée (see Aymonino, 2013, pp. 22-39). Other examples of this arrangement within Adam's work (both executed and unexecuted) can been seen in his designs for the ceilings of Lady Scarsdale's dressing room at Kedleston, the music room at Harewood, the dressing room at 15 Downing Street, and the back drawing room at 10 Hertford Street.