When Presley was making films in the 1960s in Hollywood, Red West appeared in small roles in sixteen of the star's films. During this time, West became good friends with actor Nick Adams and his physical abilities got him hired on as a stuntman on Adams' television series, The Rebel. From there, West went on to do more stunt work in film as well as developing a career as an actor in a number of motion pictures and on television. He was often on screen as a henchman in the television series The Wild Wild West.

West contributed to several songs written by Elvis Presley in 1961 and 1962. He received help from Elvis Presley in writing two songs in the early 1960s, which were collaborations: "You'll Be Gone" and "That's Someone You Never Forget".

"That's Someone You Never Forget" was the final track on the 1962 album Pot Luck. The song was released as a 45-rpm B-side single in 1967 and was featured on the Artist of the Century compilation. "You'll Be Gone" was featured on the "Girl Happy (album)" as a bonus track. West also co-wrote "If You Think I Don't Need You" with Joey Cooper for the motion picture Viva Las Vegas. He teamed up with Joey Cooper again on "I'm A Fool", which Ricky Nelson recorded. "I'm A Fool" later became a hit for Dino, Desi and Billy, the partnership of Dean-Paul "Dino" Martin, Desi Arnaz Jr., and william "Billy" Hinsche.

West also co wrote the song "Separate Ways" with Richard Mainegra for Elvis in 1972 and "If You Talk in Your Sleep" a track from Presley's 1975 album Promised Land. The latter song was written by Red West and Johnny Christopher. Red also wrote "If Every Day Was Like Christmas", recorded by Elvis Presley in 1966.

In 1976, West was involved in a series of heavy-handed incidents in Las Vegas with aggressive fans that got out of hand, drawing criticism from the media. More than that, West was becoming more vocal about Presley's drug Problem and how he needed help. As a result, West, his cousin Sonny West, and a third bodyguard named David Hebler were fired by Elvis's father, Vernon Presley, who hated most, if not all, of the members of his son's entourage.

West played Master Sergeant Andy Micklin on Baa Baa Black Sheep. He guest starred twice on the CBS hit detective series Magnum, P.I. as different characters, as five different ones on The A-Team, the Knight Rider pilot episode "Knight of the Phoenix", on The Fall Guy, Simon & Simon and in "The Once and Future King", an episode of The Twilight Zone. In 1989 West appeared in the action film Road House with Patrick Swayze as Red Webster, the auto parts store owner.

West played the lead role in the 2008 independent film Goodbye Solo as william, an elderly depressed man who befriends a Senegalese man in Winston-Salem, North Carolina. The film received positive reviews and critic Roger Ebert remarked that "West isn't playing himself, but he evokes his character so fully that he might as well be. West's face is a map of hard living".

His last film role was in the 2013 film Safe Haven as Roger, an elderly store clerk in Southport, North Carolina.

West died on July 18, 2017, after developing an aortic aneurysm, at the Baptist Hospital in Memphis. He was 81. His death occurred less than two months after the death of his cousin, actor Sonny West, in May 2017. His funeral and burial at Memorial Park Cemetery was held on July 24 in Memphis.