Tighe narrated the documentary, The Mountain Runners, examining the mountain marathon runners at Mount Hood in the early 1900s. Tighe was interviewed for America on Stage examining the development of new plays funded by the National Endowment for the Arts. Tighe appeared on a documentary that was aired on the PBS program, Independent Lens. The documentary examined the development and staging of a new play in "Playwright: From Page to Stage".

He graduated from Pasadena High School in 1962, and went on to attend Pasadena City College before receiving an undergraduate degree from USC and then an MFA for acting in 1967. After USC, Tighe was drafted into the United States Army. Due to an injury to his finger, he was stationed for two years at Fort Knox rather than being sent to Vietnam.

Tighe's first film appearance was in 1967 as fraternity brother in The Graduate, after which he appeared in two other films: Narcotics: Pit of Despair and Yours, Mine and Ours. After being discharged from the Army, Tighe appeared at the Taper Theater in Los Angeles in "The Trial of the Catonsville Nine" and in Noël Coward's "Design for Living" at the Ahmanson Theatre, also in Los Angeles. After this, he went on to perform in "Design for Living" with the National Theatre of Great Britain. During this period Tighe worked with a number of well-known actors including Lorne Greene, Maggie Smith, and Michael Landon before signing a contract with Universal Studios. During Tighe's tenure at Paramount, he appeared on NBC's Bonanza in the episode, "The Weary Willies".

Tighe auditioned for a new Jack Webb television series, Emergency! in 1972 and landed the role of firefighter-paramedic Roy DeSoto, alongside Randolph Mantooth as his partner, John Gage. DeSoto and his team would respond to vehicle crashes, medical emergencies, and other rescues in a fire department rescue squad. After receiving advice and treatment orders from a local hospital via radiotelephone, the medics performed advanced life support techniques to stabilize patients needing aid before having them transported to a medical facility.

The show ran six seasons (129 episodes) with seven two-hour television movie specials including a pilot film, The Wedsworth-Townsend Act. and averaged 30 million viewers each week. Tighe directed four episodes of Emergency!: "Gossip" (1974), "Inventions" (1974), Equipment (1975), and "Fair Fight" (1977). and wrote one episode for the show, "Up all Night" (1977). Tighe and Mantooth did many of their own Stunts in the early years of the show. Mantooth has been quoted as saying, "If you could see our faces, it was us doing the Stunts, if you couldn't, it was our stunt double."

After the cancellation of Emergency!, Tighe continued to work in episodic television, appearing on Ellery Queen, Cos, The Hardy Boys/Nancy Drew Mysteries, The Six Million Dollar Man, and The Love Boat. He also appeared on the CBS Library production of "Orphans, Waifs, and Wards" and as Thomas Jefferson in an adaptation of the John Jakes novel The Rebels in 1979.

During the 80s, Tighe taught drama at USC. To keep his acting skills honed, he once again studied acting, this time with Robert Lewis and Stella Adler in New York City. He worked in summer stock as part of a company directed by Alfred Christie at the Hampton Playhouse in 1980, and performed in Come Blow Your Horn. In 1983, Tighe was cast in Two for the Seesaw at william Putch's Totem Pole Playhouse in Caledonia, Pennsylvania.

Tighe made his Broadway debut at the Music Box Theatre in the play, Open Admissions; the show closed after two weeks. He then acted in Night of the Iguana with McCarter Theatre Company, in Princeton, NJ; Mark Weller's The Ballad of Soapy Smith in 1983 at the Seattle Repertory Theatre in Seattle; and the New York Shakespeare Festival at the Public Theatre in New York City. In 1989, he received an NEA fellowship at the Seattle Repertory Theatre. Tighe also wrote and directed Homegirl for the Seattle Repertory Theatre in 1986.

Since 1985, Tighe has resided in Skagit County, Washington with his wife, the Artist Rebecca Fletcher.

After returning to Los Angeles in 1986, Tighe began working again in television and movies. His late 1980s movie appearances were in Matewan, Eight Men Out, K-9, and as club-owner Frank Tilghman in 1989's Road House with Patrick Swayze. During a 2006 interview, Tighe stated, "I've gotten more comments on that movie than any other film I've ever done." Saying he is amazed by the film's broad audience appeal, he further said, "Working class people like it, (college kids), white people, black people. I think a lot of that is due to the music ... the movie had great music."

Tighe continued to work in theater and appeared in three different roles: Hilton Lasker, Swifty, and Lord Kitterson in The End of the Day: An Entertainment at the Seattle Repertory Theatre, in 1989 and 1990. Tighe continued to do plays in the 1990s at the Seattle Repertory Theatre including Hedda Gabler in 1992.

Tighe's work in the 1990s included work on episodic television crime, drama, and science-fiction programs. Tighe appeared on episodes of Murder, She Wrote, Tales from the Crypt, Under Suspicion, Chicago Hope, The Single Guy, ER, The Outer Limits. For six episodes, he portrayed police detective David Blalock on the crime and legal drama, Murder One and Henry Janeway, an ancestor of Captain Kathryn Janeway, in the Star Trek: Voyager episode "11:59".

Tighe's roles in feature films included lawyers, law enforcement officers, and military figures including the part of Blake Wilson in the Eddie Murphy and Nick Nolte vehicle Another 48 Hrs. Other film roles during this period were in Bright Angel, City of Hope, Newsies, School Ties, and Mumford. Tighe portrayed Ken Carver in What's Eating Gilbert Grape and Brigadier General Nelson Miles Geronimo: An American Legend. In 1994, he won a Genie Award for Best Supporting Actor in the role of "Frank" in I Love a Man in Uniform.

Besides episodic work, Tighe appeared in a number of television movies during the 90s, including Perry Mason: The Case of the Defiant Daughter, the remake of Escape to Witch Mountain, and slain Kansas father and farmer Herb Clutter in the 1996 miniseries adaptation of Truman Capote's book In Cold Blood. Tighe also portrayed newspaper legend william Randolph Hearst in Winchell.

Tighe worked in regional and repertory theater, with the bulk of his stage work in Seattle. Tighe played Mick Dowd, a gravedigger, in Martin McDonagh's A Skull in Connemara at ACT Theatre in Seattle in 2000. Six months later, the production moved to New York, where it played at the Roundabout Theatre Company and Gramercy Theatre.

He played Brigadier General Ezra Mannon in Mourning Becomes Electra and the play was initially performed at the ACT Theatre with Jane Alexander in 2001. The play was staged later in 2001 at the Long Wharf Theatre in New Haven, Connecticut with Tighe and Alexander in the cast. Tighe worked with his daughter, Jennifer, in A Reckoning at the Magic Theater in San Francisco. Tighe played Matt in Anna Christie, along with Sam Shepard's Buried Child, and Yuri Lubymov’s production of Crime And Punishment on The Arena Stage at the Kreeger Theatre in Washington, D.C.

During the series' run and after it was cancelled, Tighe became and remained friends with Mantooth as well as London and Troup. Tighe served as a best man at Mantooth's second wedding in 2002. Through his friendship with Troup and London, who were married to each other as well as recording artists prior to being cast on the show, Tighe had the opportunity to meet well known jazz Musicians and artists.

In order to better portray his character, Tighe, along with other actors on the show, sat in on paramedic classes and participated in "ride-alongs" with the LA County Fire Department. When the show premiered, there were only 12 paramedic units in North America; the show is credited with introducing its audience to the concept of pre-hospital care, fire prevention, and CPR. In a 2006 Seattle radio interview, Tighe stated that Emergency! "...resonated with working people and I was always very proud of that fact. It promoted the paramedic program."

Tighe played the title role in Rajiv Joseph's Pulitzer Prize-nominated drama Bengal Tiger at the Baghdad Zoo, about the lives of American Soldiers who guard a philosophical tiger (Tighe) while on duty in the Iraq War. Tighe played the role in both the New York and at the Mark Taper Forum in Los Angeles productions, replacing Robin Williams, He won positive reviews for his performance of the Tiger. He won a 2010 Garland Award for best Performance in a Play.

Tighe played Fredrik in Anatomy of Pain on the Mirror Stage at the Ethnic Cultural Theatre in Seattle in 2012. In Sam Shepard's Curse of the Starving Class, Tighe played Weston in 2013 at the Long Wharf Theatre in New Haven with Judith Ivey. He had the following thoughts in his approach to doing Shepard's play,"You have to beware of naturalism, which is the place actors tend to go into. You have to leave the ground for awhile and then hope you land." Later in 2013, Tighe played Lyman Wyeth in Other Desert Cities with Pamela Reed at ACT Theatre in Seattle.

Tighe played Captain Channing on Trauma. His recent episodic television work includes Common Law, Complications, and Salem. His most recent film appearance is I am I, released in June 2014.