[5] As the firm's billings grew in the late 1950s, it opened offices in New York City and Washington, D.C.[5] It acquired west coast-based agency Botsford Constantine & McCarty, forming Botsford-Ketchum in 1969.

[14] In the 2000s, Ketchum acquired several firms and opened others, including the acquisition of New York management consulting firm Stromberg Consulting in 2001,[15] the launching of influencer marketing and community building firm Emanate in 2006,[16] and the acquisitions of clinical trial patient recruitment agency MMG in 2008,[17] Moscow-based Maslov PR in 2010,[18] Indian agency Sampark PR in 2011,[19] Capstrat in North Carolina in 2012,[20] and German lifestyle and social media PR agency Brandzeichen in 2013.

[28][29] Ketchum's major clients include MasterCard,[30] Chase, IBM,[31] IKEA,[32] Philips,[33] and Pfizer.

[34][35] Ketchum also worked on the rebranding of Orville Redenbacher's popcorn in the 1990s to appeal to a younger demographic,[36] developed Doritos' 2006 crowdsourced "Crash the Super Bowl" contest, which won a Golden World Award from the International Public Relations Association,[37] and created a campaign for Delta Air Lines during US Airways' 2008 bid to take over the airline after it had filed Chapter 11 bankruptcy.

[47] In 2011, Pennsylvania State University hired Ketchum to handle crisis communications following the Jerry Sandusky scandal in 2011.

[50][51] In 2015 the agency worked with the Library of Congress to provide support for the National Book Festival.

[52] In 2004, Ketchum was accused of "covert propaganda" for a series of news stories for HHS that used actors playing journalists reporting on drug benefits without informing viewers of the government connection, for which it was found to be in violation of a federal propaganda ban by the Government Accountability Office.

[55] In 2006, Dmitry Peskov, Vladimir Putin's press attaché, hired Ketchum to work on the 32nd G8 summit held in Saint Petersburg, to improve Russia's reputation in the West after its state-controlled energy company Gazprom cut off natural gas supplies to Ukraine.

[56] From 2006 to 2015, Ketchum represented the Russian Federation in the US and Europe[57] for events including the G20 Summit, World Economic Forum, and 2014 Sochi Olympics, media and op-ed outreach.

[58][59] In 2013, Ketchum pitched an op-ed from Russian president Vladimir Putin on the Syrian Civil War to The New York Times.

[60] According to The Holmes Report, the assignment "attracted plenty of mainstream media scrutiny in the US, most of it negative" due to the countries' political relationship.

As of 2016, Ketchum has won more Silver Anvils from the Public Relations Society of America than any other agency.

Other leadership roles include President of North America, Tamara Norman, and Global Chief Financial & Operating Officer Alan Banner.

[70] Ketchum developed a program called MindFire for college students to respond to client challenges with creative solutions in order to earn prizes and networking opportunities.