The NBA Rookie of the Year, Sampson averaged 20.7 points and 10.9 rebounds for his first three seasons with the Houston Rockets before injuries began to take their toll.
However, he did get a form of revenge against Bowie, outplaying him in the Capital Classic, getting 23 points and 21 rebounds with 4 blocks in a game styled "Battle of the Giants".
Many observers criticized the Rockets' choice, believing the two 7-footers (known as the Twin Towers) would not be effective playing together, while others thought the combination could be overpowering.
At the time, Dallas Mavericks Coach Dick Motta said, "That front line, when history is written when they've grown up, might be the best-assembled on one team.
Sampson experienced his first scare with injury during a game on March 24, 1986, when an attempt to grab a rebound against the Boston Celtics saw him land awkwardly with his head driven into the court.
He had a severely bruised back and missed three games; team president Ray Patterson later contended that Sampson was never quite the same after that injury.
In the playoffs, the Rockets swept the Sacramento Kings, but faced a stiffer challenge against Alex English and the Denver Nuggets in the Conference Semi-Finals, eventually winning the series 4–2, with the sixth and deciding game going to double overtime.
[9] With the score tied at 112, Olajuwon having earlier been ejected, and with only one second remaining on the clock, Sampson took an inbounds pass and launched a twisting turnaround jumper that bounced twice, and went through the hoop at the buzzer, giving the Rockets a 114–112 victory and a shocking series upset.
At the start of the Finals, Sampson quickly found himself in foul trouble early in Game 1 as Boston easily went up 2-0 going back to Houston.
Game 4 also went down to the wire with the Celtics pulling it out on late Larry Bird 3-pointer heroics and untimely turnovers by Rockets guard Mitch Wiggins.
Strangely, this fired up the Rockets, who won Game 5 by 15 points without him thanks to the inspired play of Olajuwon, Jim Petersen, and Robert "Bobby Jo" Reid.
Game 6 went back to Boston with Sampson finding himself again in foul trouble and of little effect against the older and wiser Celtic frontcourt of Larry Bird, Kevin McHale and Robert Parish.
During the six-game championship series loss against the Celtics, Sampson averaged 14.8 points on .438 shooting, 9.5 rebounds and 3.3 assists per game.
On February 4, 1987, he suffered a major cartilage tear in his left knee against the Denver Nuggets, which happened when his right foot slipped.
There were reports of him having slipped due to remnants of solvent used to clean off scuffs done on the court by a drill team practicing their show before the game.
Sampson averaged 6.4 points and 5.0 rebounds with Golden State in 1988–89 and was traded during the offseason to the Sacramento Kings for Jim Petersen.
[19] In 2002, he was named to the ACC 50th Anniversary men's basketball team as one of the 50 greatest players in Atlantic Coast Conference history and one of only three Virginia Cavaliers so honored.
[23] Their younger son, Robert, transferred to Georgia Tech after playing his first three seasons (2010–2013) of college basketball for East Carolina University.