[6] The weekend after Thanksgiving in his senior season, Randle fractured his foot playing in a tournament and missed three months as a result.

He then joined twin brothers Andrew and Aaron Harrison, James Young, Dakari Johnson and Marcus Lee as the sixth incoming Kentucky player selected to play in the 2013 McDonald's All-American Boys Game, as well as the 2013 Jordan Brand Classic.

[11] On April 22, 2014, Randle declared for the NBA draft, foregoing his final three years of college eligibility.

[13] On October 28, 2014, after only 14 minutes of official NBA playing time, Randle broke his right tibia during the Lakers' 2014–15 season opener against the Houston Rockets.

[14] He underwent successful surgery the following day to repair the fracture,[15] and subsequently missed the rest of the season.

[17] Exactly a year after injuring himself in his NBA debut, Randle had 15 points and 11 rebounds as a starter in a 112–111 season-opening loss to the Minnesota Timberwolves.

[21] On March 25, he recorded his first career triple-double with 13 points, 18 rebounds and a then career-high 10 assists in a 116–105 loss to the Denver Nuggets.

[28] On December 31, Randle set season highs with 29 points and 15 rebounds in a 148–142 double overtime loss to the Houston Rockets.

[32][33] In his debut for the Pelicans in their season opener on October 17, Randle had 25 points off the bench in a 131–112 win over the Houston Rockets.

[34] On November 19, he recorded his sixth career triple-double with 21 points, 14 rebounds and 10 assists in 25 minutes in a 140–126 win over the San Antonio Spurs.

[44] On April 16, Randle tied his season high 44 points, while also recording 10 rebounds and 7 assists, to lead the Knicks to a 117–109 victory over the Dallas Mavericks.

[45] After the end of the regular season, Randle was named the NBA Most Improved Player, receiving 98 of 100 first place votes.

[52] On March 22, Randle was fined $40,000 by the NBA for an incident with a game official, which occurred two days earlier during a 108–93 loss to the Utah Jazz.

[53] On April 2, Knicks head coach Tom Thibodeau said that Randle would "likely" be out for the remainder of the season with a quad injury.

[59] On March 3, Randle scored 43 points, grabbed nine rebounds and made a game-winning three-pointer in a 122–120 win over the Miami Heat.

[61] On March 30, the Knicks announced that Randle would be out for at least two weeks with a left ankle sprain, which he suffered during a game the day earlier against the Miami Heat.

Coming back from injury in Game 1 of the 1st Round vs the Cleveland Cavaliers, Randle had a strong showing scoring 19 points to go along with 10 rebounds, 4 assists & 2 steals in a win on the road.

[66] On October 22, 2024, Randle made his Timberwolves debut, scoring 16 points, nine rebounds and four assists, in a 110–103 loss to his former team, the Los Angeles Lakers.