This study investigates the influence of topography on wind turbine flow and power efficiency. Specifically, a standalone wind turbine is positioned at the top of idealized two-dimensional hills, and the effects of hill geometry and turbine position are systematically investigated. Various parameters are studied, including hill slope, distance between the leeward side of the hill and the turbine, turbine hub height, and hill size. Overall, it is observed that the turbine wake is consistently stronger in the hill cases compared to the flat case. This is attributed to two characteristics of hill flows: (1) the negative streamwise velocity gradients on the leeward side of the hills and (2) the reduced turbulence above the hilltops and hill wake regions. In addition, it is observed that the turbine induction factor is consistently increased in the hill cases compared to the flat case, while the turbine power and thrust coefficients are reduced. In practice, this means that turbines on the hills produce less power output than those on flat terrain for an equivalent wind potential, with the potential decrease in power output reaching more than 20% for certain cases. Altogether, the results offer new insights into the effect of topography on turbine power efficiency. In addition, the study identifies clear relationships between the turbine power coefficient, the induction factor, the overall maximum deficit, and the base flow pressure gradient. These relationships could potentially be used to predict the change in power efficiency based on the wake flow or the base flow. Overall, the results show a clear connection between the turbine power efficiency and the turbine wake development.