His son Nathan Ryno Smith, was a professor at many medical schools, with the later part of his career spent at the University of Maryland.
A grandson through a different son, Nathan Lincoln Smith (1822–1898) was a professor of medicine at George Washington University.
Her younger son, Elisha Warfield Theobald Jr., (1850–1877) was a physician but did not live long enough to make a great impact on the profession.
However Samuel Theobald, Sarah's older son, became head of the American Ophthalmological Society and was from 1893 to 1925 an active professor at Johns Hopkins University (he was emeritus for the next five years until his death).
Sarah also had a daughter whose son Warfield Theobald Longcope was also a professor at Johns Hopkins University.