Astrid Holm made her screen debut for Dansk Filmfabrik in 1917's Søstrene Morelli (The Sisters Morelli) and the following year was under contract to Nordisk Film. Her first film for Nordisk was a role in the 1918 Holger-Madsen-directed Folkets Ven (The People's Friend), opposite Gunnar Tolnæs and Svend Kornbeck. This was followed by several popular films for Emanuel Gregers. One of her most popular roles was as Sister Edith in the 1921 Victor Sjâstrâm-directed Swedish silent Kârkarlen (The Phantom Carriage). The film was based on the 1912 novel Thy Soul Shall Bear Witness! by Nobel prize-winning Swedish author Selma Lagerlâf. In 1925 she starred opposite Johannes Meyer in the Carl Theodor Dreyer-directed drama Du skal ære din hustru (Thou Shalt Honor Thy Wife). This would be Holm's last film role for many years.
Astrid Holm returned to film in 1942's Ta' briller pΓ₯, directed by Arne Weel and starring Liva Weel and Hans Egede Budtz. She would appear in four more films throughout the 1940s before retiring from the screen due to failing health. Her final film appearance would be in the 1947 Holger Gabrielsen-directed Mani.
Astrid Holm was married to ballet dancer Holger Holm, who died in 1916. During the 1950s, she became reclusive, suffering from a number of ailments. She died in 1961 at age 68.