Ketchum's 1991 album Past the Point of Rescue was his most commercially successful, having been certified gold by the Recording Industry Association of America.

Four singles were released from the album: "Small Town Saturday Night" was first, achieving a peak of number two on the Billboard Hot Country Songs chart.

Also peaking at number two was the title track, written by Irish musician Mick Hanly and originally a hit single in Ireland for Mary Black in 1988.

The last single from the album was a rendition of The Vogues' "Five O'Clock World", which Ketchum took into top 20 of Hot Country Songs in 1992.

Among the musicians contributing to the album were Mattea, Gary Burr, and Richard Bennett, as well as Bruce Bouton, Chris Leuzinger, and Milton Sledge of Brooks' studio band The G-Men.

[4] Alanna Nash of Entertainment Weekly rated the album "A−", stating that "Literate and tuneful, Past the Point of Rescue balances poetic love songs with a squint-eyed look at teenage rebellion, romance, and psychological intrigue, all delivered with a tenor that throbs with passion and conviction.

Ketchum wrote the first two singles, "(Tonight We Just Might) Fall in Love Again" and "That's What I Get for Losin' You", with former NRBQ member Al Anderson.

[3] After it came Ketchum's last top-ten hit "Stay Forever", which he wrote with Benmont Tench; the title track and its B-side, "Trail of Tears", both fell short of the top 40.

Ron Wynn, reviewing Past the Point of Rescue for AllMusic, wrote that Ketchum "writes simple, sometimes moving songs about relationships and/or life's dilemmas, and communicates them in an attractive, unadorned vocal package" and said that his "delivery, as well as the arrangements and sensibility, lean toward easy listening pop and light folk.

"[10] Also reviewing the same album, Mike Curtin of The Post-Star described Ketchum as having a "plaintive tenor voice" with comparisons to Roy Orbison and Lyle Lovett.

[13] On April 14, 2019, Ketchum's wife, Andrea, announced on his Facebook page that early-onset senile dementia including Alzheimer's disease had progressed to the point that he could no longer perform.