Many of his photographs explore issues of gay identity, homoeroticism, and living with AIDS, linking his work to that of contemporaries such as Robert Mapplethorpe, Peter Hujar, and David Wojnarowicz.

In the fall of 1966, Lebe enrolled at the Philadelphia College of Art (PCA), where he studied photography with Ray K. Metzker, Barbara Blondeau, and Tom Porett.

All three were graduates of Chicago's Illinois Institute of Technology, founded by László Moholy-Nagy as a successor to Germany's Bauhaus, with a strong tradition of experimentation.

It was in Blondeau's class in 1969–70 that he began to experiment with pinhole cameras, building his own devices with multiple apertures that allowed him to record panoramic views of the same subject from various angles.

His senior thesis, Form without Substance, consisted largely of high-contrast images with strong black shadows taken in Philadelphia and around his childhood home in Manhattan.

“An experimentalist less interested in capturing the real than in freeing his images from the constraints of reality,”[2] he has produced multiple bodies of work that explore an array of subjects, often utilizing fundamental, relatively low-tech photographic techniques in innovative ways.

"By opening and closing the apertures at different times, Lebe could create a single, scroll-like print of the whole event, transmuting it into a dreamy collage of social interactions.

"The vision of the world Lebe’s pinhole photographs offer ultimately doesn’t feel so decisive at all," wrote poet and critic Jameson Fitzpatrick.

After finding a hand-coloring set in a camera store in New York, he began hand painting gelatin-silver prints, including pinhole images and photograms, and traditional photographs.

In 1974–75 he created a series of images he called Unphotographs, meticulously hand-painted black-and-white photographic portraits of himself and others, often choosing colors that bore no relation to the actual subjects.

"[7] Like the earlier pinhole photographs, the light drawings required long exposure times, allowed Lebe to come out from the behind the camera and interact with his subjects.

In 1987, following the death of a close friend from AIDS and just before his own HIV diagnosis, he began creating abstract, figureless photos drawn freehand with a flashlight.

Calling them Scribbles, Lebe made a number of these images, which often feature light emerging from a glass vase in the middle of a darkened space.

"Despite their relatively banal content, the photographs are heavy with the weight of illness and the knowledge not only of one’s own mortality, but also of a beloved’s," wrote Jameson Fitzpatrick in Art in America.