A 7 ft 0 in (2.13 m) center from Kentucky State University, he played in the National Basketball Association (NBA) from 1971 to 1979.

He was a member of the Buffalo Braves, Los Angeles Lakers, Milwaukee Bucks, and Cleveland Cavaliers.

But after sprouting to 7 feet over the next two years, Smith said, "The principal threatened me: 'If you don't go out for basketball, we're going to kick you off campus.'

He was a member of the 1970 and 1971 NAIA Championship teams, coached by Lucias Mitchell, playing alongside teammate Travis Grant.

[5] On the other hand, Smith, who missed more than half of his free throw attempts during the regular season, had an unusual performance in a, in a 106 to 89 loss to the Atlanta Hawks on December 28, 1974, when he failed in three consecutive shots from the free throw line (under the now defunct ""three to make two" rule in the NBA at the time) with all three attempts being an "air ball" where the ball basketball failed to hit the basket, the rim or the backboard.

He was traded by the Los Angeles Lakers with Junior Bridgeman, Dave Meyers and Brian Winters to the Milwaukee Bucks for Kareem Abdul-Jabbar and Walt Wesley.

[7] Smith was plagued by a knee injury, that required surgery, and played in only 24 games for Cleveland in 1978–79, the last of his career.

His sauces are served at Elmore Smith's Smokehouse Restaurant located in Cleveland's Rocket Mortgage FieldHouse or online.