Undrafted out of junior, Sanford was signed as a free agent by the St. Louis Blues after his final year with the Platers in 2000,[1] and spent his first five seasons in the club's farm system between the Peoria Rivermen of the ECHL and Worcester IceCats of the American Hockey League (AHL).

Sanford earned a call-up with the Blues during the 2002–03 season after injuries to goaltenders Fred Brathwaite and Brent Johnson in October.

He played in his first game when fellow rookie call-up Reinhard Divis also went down with an injury after the first period on October 17, 2002, against the Columbus Blue Jackets.

[2] Sanford briefly earned the starting position in the absence of the Blues' usual goaltenders before going down with an injury himself, a high-ankle sprain, on October 24 against the Edmonton Oilers.

However, as Lalime struggled, Sanford seized the starting position and was having a career year until going down with a sprained ACL in his left knee in March.

Sanford became an unrestricted free agent in the off-season and on July 3, 2007, the Vancouver Canucks signed him to a one-year, $600,000 contract to back-up starting goaltender Roberto Luongo.

[15] With both Jaroslav Halák and Carey Price minding net, Sanford was assigned to the Canadiens' AHL affiliate, the Hamilton Bulldogs.