Unlike most teams with high draft picks, the Pistons were a good team and had made the Eastern Conference Finals the season before they held the pick because of a trade that had been made with the Vancouver Grizzlies in 1996. During his time with the Pistons, Miličić won an NBA championship in 2004 but, saw limited playing time. His selection by Detroit was largely praised at the time, as he was considered the top European prospect. However, as Miličić failed to enter the team's rotation. The selection has been widely second-guessed by many, who have argued that the Pistons should have taken Carmelo Anthony, Chris Bosh, or Dwyane Wade; all of whom were available at the time Miličić was taken. The criticism was tempered somewhat due to the excellent team chemistry displayed by the Pistons during their championship run.

Under coach Larry Brown (2003-2005), Miličić only played when the Pistons had an insurmountable lead late in the game. This earned him the somewhat derisive nickname of "The Human Victory Cigar." Pistons team president Joe Dumars repeatedly stated that Miličić will play a big part in the team's future, but he did not see a large increase in playing time during his second season. Miličić has been quoted on numerous occasions as blaming his slow development on his lack of playing time: "I've said it 10,000 times, the best way for me to improve is to play. All the work in practice and individual workouts can only help me so much." After Brown's departure, Flip Saunders was hired as head coach of the Pistons. It was expected that Miličić would see more playing time due to Saunders's track record of developing young players such as Kevin Garnett and Stephon Marbury. While Brown has a well-known preference for veterans, Saunders was seen as more willing to give on-the-job training. With Elden Campbell no longer on Detroit's roster and Dale Davis only brought in as a mentor, most NBA experts believed that Miličić would see considerably more minutes this season as the Pistons' full-time backup center behind Ben Wallace. While Darko played very well in the NBA's summer leagues and earned the praise of his teammates, little changed in the first half of the 2006 season. Under Saunders, Miličić still averaged only 5.6 minutes per game, and received significant playing time only in blowout wins or blowout losses for the Pistons. Darko's surprising lack of playing time in Detroit was frequently highlighed in publications like ESPN The Magazine and Sports Illustrated, and at fan websites like FreeDarko, a page devoted to lobbying for Miličić to receive additional playing time.

On February 15, 2006, just prior to the NBA's All-Star break, Miličić was traded, along with point guard Carlos Arroyo, to the Orlando Magic for Kelvin Cato and a first-round pick in the 2007 NBA Draft. This was rumored to be the result of Miličić being very unhappy about his lack of playing time and possibly requesting a trade.

During a game against the New York Knicks he played 32 minutes and finished with 13 points and 7 rebounds. The 13 points and 32 minutes were season highs and he led the Magic in minutes for that game. Orlando Magic management has been impressed with Darko and some consider him a more refined offensive player than Dwight Howard. Darko has also exhibited his abilities as a shot blocker by averaging 2.4 blocks per game in his first 20 games as Magic. Had he averaged that over the course of the season, he would have had the 7th highest average blocks per game in the league in 2005/6.