Following law school graduation, Rufe served as a public defender in Bucks County, Pennsylvania, spending much of her tenure there in the juvenile division.

She practiced in her own firm for 11 years, gaining prominence in the local legal community.

In 1994, she was elected as a judge of the Bucks County Court of Common Pleas, where she served for eight years, until 2002.

On the recommendation of Senators Arlen Specter and Rick Santorum, Rufe was nominated to the United States District Court for the Eastern District of Pennsylvania by President George W. Bush on January 23, 2002 to a seat vacated by Judge Norma Levy Shapiro.

Rufe was confirmed by the United States Senate on April 30, 2002 and received her commission on May 3, 2002.