Derek Smith grew up in Corinth, Georgia and attended high school in the nearby city of Hogansville.

He won two state basketball championships with Hogansville High School, yet was not included in any college recruiting publication.

He was one of the starters for the 1980 University of Louisville Cardinals basketball team which won the NCAA championship, defeating UCLA 59–54.

At the request of Portland Trail Blazers general manager Stu Inman, Smith received a try out with the San Diego Clippers.

However, hobbled by injuries and tendinitis in his left knee, Smith struggled to stay on the court and fulfill the expectations the franchise had placed on him.

In this decisive game, Smith came off the bench to score 12 key points and provide rugged defense against Chuck Person.

[13] Smith managed to participate in the contest thanks to a knee injection, and his contribution drew heavy praise from teammate Larry Bird.

On August 9, 1996, while the ship was near Bermuda and returning to New York City, Smith suddenly suffered an apparent massive heart attack during a farewell cocktail party in the presence of members of his team.