He was the head football coach at the University of Hawaii at Manoa, a position he held from December 2011 until November 2015 and previously held the offensive coordinator position for the Utah Utes, UCLA Bruins, the NFL's Tennessee Titans, USC Trojans, NC State Wolfpack, and BYU Cougars.

The list of players he coached includes Jim McMahon, Steve Young, and Philip Rivers, as well as Heisman Trophy winners Ty Detmer, Carson Palmer, and Matt Leinart.

Chow played college football at the University of Utah, and was a two-year starter and a three-year letterman offensive guard for the Utes.

He then played briefly in the Canadian Football League, for the Saskatchewan Roughriders, before an injury ended his professional athletic career.

In 1983, the offense, led by quarterback Steve Young, set NCAA single-season records for pass completion percentage (71.3%) and total yards per game (584.2).

[12] In 1990, the Cougars upset defending national champion and top-ranked Miami, FL., 28–21, with nearly 500 yards of offense and Ty Detmer went on to win the Heisman.

[12] That season, the Cougars with Steve Sarkisian as quarterback, won the WAC and earned its first ever New Year's Day Bowl.

[15] Under Chow's tutelage, quarterback Philip Rivers broke seven school passing records and was named ACC Freshman of the Year.

[16] In 2001, Chow accepted Pete Carroll's offer to serve as the offensive coordinator at USC, and became one of the highest-paid assistant coaches in the country.

In 2004, quarterback Matt Leinart won the school's sixth Heisman trophy and USC trounced Oklahoma 55–19 in the BCS National Championship.

[18] On January 15, 2008, after being fired by the Titans following the 2007 season, Chow was hired by new UCLA Bruins head coach Rick Neuheisel as offensive coordinator.

[20] Chow was immediately hired as the offensive coordinator of the Utah Utes, a team that was getting ready to enter its first season in the Pac-12.

[23] On November 1, 2015, Chow was fired as head coach of the University of Hawaii after suffering a 58–7 loss at home against Air Force.

[25][26] Chow left Van Nuys to be an assistant coach at Mira Costa High School in Manhattan Beach for the 2016 regular season.

[27] On June 12, 2019, new XFL franchise Los Angeles Wildcats announced Chow had been hired as their offensive coordinator.

[28] In August 2022, Chow was named the first head coach of the Helvetic Guards ahead of their first season in the European League of Football.