A singer, songwriter and multi-instrumentalist, Smith rose to prominence as the frontman of the rock band Cardiacs,[5] which he co-founded with his brother Jim.

Smith was also a producer of records or promotional videos for acts including Oceansize, Sepultura, Dark Star, The Frank and Walters, Sidi Bou Said, Eat, the Scaramanga Six and Wildhearts frontman Ginger.

[9] He grew up in Chessington where he was primarily raised by his mother Eileen, a dinner lady at the primary school he attended with his older brother Jim.

Some songs written by Smith at around age 13, notably "Interlude" from their debut album and "Billion" from Sing to God, would later be made into Cardiacs tracks.

[13] He played his first gig at the age of 16 as Gazunder alongside the Sound frontman Adrian Borland and rock drummer Bruce Bizland at Surbiton Assembly Rooms,[11][14] which sounded like the rock instrumentals on David Bowie's The Man Who Sold the World (1970), [15] and drew inspiration for his first guitar experiments after having briefly played bass before passing the task to Jim.

[11] After another line up change, Smith recruited Tim Quy (percussion), Sarah Cutts (saxophone) and Dominic Luckman (drums).

[25] In March 2006, Smith toured with Ginger & The Sonic Circus as their support act, performing acoustic versions of Cardiacs' songs, along with his own material.

"[29] Smith's heart attack had triggered a major stroke and an episode of cerebral anoxia[30][4] which was treated in intensive care at University College Hospital.

Although there was some initial optimism[31][29] - according to Craig Fortnam, "he was sat up in bed and smiling",[29] - Smith was thought to have had had a second stroke in hospital a few days later while he recuperated.

[38][39] In 2013, 2015 and 2017, events dubbed The Alphabet Business Convention were held in celebration of and with all proceeds funding Smith (who attended) and his ongoing recovery.

[45] Notable musicians including JG Thirwell, Craig Fortnam, Mike Vennart, Shane Embury, and Cardiacs' own Kavus Torabi paid tribute following this event.

[46] Further fundraising events were held in 2018 and 2019, featuring live music from Cardiacs members and related bands, film screenings and interviews, with Tim Smith sporadically in attendance.

[56] A raft of luminaries paid tribute: Mike Patton sent "tons of love" to Smith, noting that his musical ethos was conducted "independently and with no apologies", whilst Devin Townsend called him "one of the finest ever" and Napalm Death bassist Shane Embury, known for his fast, frantic playing, cited Cardiacs as causing him to write speedier riffs.

[57] Other bands and artists including the Magic Numbers, Calling All Astronauts, Chris Catalyst, Dutch Uncles, Porcupine Tree frontman Steven Wilson, Graham Coxon of Blur, Voivod guitarist Dan "Chewy" Mongrain, Pinback frontman Rob Crow, JG Thirlwell of Foetus, Oceansize frontman Mike Vennart, electronic musician Max Tundra, industrial metal band Pitchshifter, Silvery, writer and musician Rhodri Marsden, Ginger Wildheart, as well as television and radio personality Matthew Wright, also paid tribute on social media.

[66] Smith created and/or edited pop videos for various bands including Sepultura, Dark Star, Zu and the Frank and Walters, as well as Cardiacs.

Smith has declared a fondness for musical acts such as Genesis, Gentle Giant, Split Enz, XTC, Devo, Sparks, Magazine, Queen, Mr. Bungle, Naked City, My Bloody Valentine, Foetus, Pixies, Roxy Music, Faust, Tom Waits, Blur, Supergrass, Frank Zappa, the Monkees, Can, The Gasman, the Beach Boys, the Beatles, the Incredible String Band, the White Noise, Everything Everything as well as the orchestral work of Charles Ives and Ralph Vaughan Williams, and composers like Philip Glass and Steve Reich.

"[69] -Margen Magazine (Spain) April 2001, Tim Smith InterviewSmith married Sarah Cutts on 23 July 1983,[70] who had joined Cardiacs as a multi-instrumentalist in 1980.

[33] The pair separated in the early 1990s and the marriage ended in divorce, with Sarah leaving Cardiacs in 1990 to "be a full-time witch and live in the woods with the snails" whilst remaining in the Sea Nymphs.

[7] Appearances With the Sound With Shrubbies With Adrian Borland With Spratleys Japs With William D. Drake With Two Worlds Collide With Ginger With the Scaramanga Six With Pinhead Nation With North Sea Radio Orchestra