Dr. Milo Smith attended the Philadelphia Medical School where he studied medicine and earned his M.D.

Their daughter, Elizibeth Nisbet Smith, was the first white child born in the city of Chattanooga after its naming and their son, William Spotswood Smith, attended the medical school in Nashville and later worked on the medical staff for Dr. Samuel H. Stout in the Confederate Army.

He served as mayor again in from 1862 and 1863 until his office was abrogated by the Union Army during the occupation of Chattanooga.

He was widely considered a very kind man throughout the city due to his persistence to give free medical care.

Smith's charitable demeanor made him very popular among the people and likely contributed to his being elected to the mayor's office so frequently.