[citation needed] She was on the cover of Vogue magazine at the age of 15 and has been modeling ever since, and has featured in films and television programs.

[3] At the age of 13, while riding a bus to ballet class, she was approached to model by the wife of photographer Herman Landschoff.

11, as Little Red Riding Hood, Snow White and Cinderella along with model Dorian Leigh, actors Ray Bolger and Jose Ferrer.

Mark Shaw photographed her for a classic Vanity Fair lingerie campaign, in which Dell'Orefice obscures her face with her hand.

In 1993 she appeared in The Babe Business, a feature documentary filmed in New York about models directed by Don Boyd for Channel Four television.

On July 19, 2011 she was awarded an honorary doctorate from the University of the Arts London, in recognition of her contribution to the fashion industry.

The university sponsored a retrospective exhibition curated by illustrator and long-time friend David Downton, featuring Dell'Orefice's Vogue covers, career highlights, and photographs from her personal archives.

In 2015, Dell'Orefice collaborated with David Gandy and Isabeli Fontana in the promotion for the reopening of the department store Palacio de Hierro Polanco.

[10] She has also featured on the covers of L'Officiel (Australia, Azerbaijan, Switzerland), Marie Claire Arabia and Harper's Bazaar Thailand.

For twelve years, Ruth and Bernie Madoff and Dell'Orefice and Norman Levy were a "foursome", traveling and partying together on lavish yachts.

In December 2008 a 68-year-old friend, who invested her life savings with Madoff, telephoned Dell'Orefice to inform her that she too had been bankrupted by the scheme.