Thomas F. Frist Jr. was born on August 12, 1938. His Father was Thomas F. Frist Sr., a prominent internal Medicine specialist in Nashville. His mother was Dorothy Cate. He has four siblings: physician and former U.S. Senate Majority Leader Bill Frist; Dr. Robert A. Frist; Dorothy F. Boensch; and Mary F. Barfield.

Frist grew up in Belle Meade on the west side of Nashville. He attended Montgomery Bell Academy, a Nashville prep school for boys. In 1956, Frist played quarterback for MBA's state championship football team. Frist's halfback on the team was Frank Drowota, who became the chief Justice of the Tennessee Supreme Court. Frist graduated from Vanderbilt University and received an MD from Washington University in St. Louis. He was a brother of the Vanderbilt chapter of Phi Delta Theta. He served as a FLIGHT surgeon in the United States Air Force.

In 1968, he co-founded the Hospital Corporation of America with his Father, Thomas F. Frist Sr., and Jack C. Massey.

In 1977, he became President of HCA and, in 1987, chairman, President and chief executive officer (CEO). He served as chairman in 1994, after the merger with Columbia, and after the merger with HealthTrust Inc. in April 1995, as vice chairman. He returned as chairman and CEO of the company in 1997 after the resignation of Rick Scott.

From 1984-95, he served on the board of Ddirectors of IBM. He was the chair of the Nashville Area Chamber of Commerce from 1999-2000. He is a member of The Business Council. In 2008, he co-founded the China Health care Corporation with Charles A. Elcan. They have Business interests in Cixi, China. He is President of Okeechobee Hospital Inc. and Galen Of Florida Inc.

He was inducted into the Health care Hall of Fame. He served as vice President of the Vanderbilt University board of trust from 1995 to 1997. He is a recipient of the distinguished graduates award of Vanderbilt University. He is chairman of the Frist Foundation and the Frist Center for the Visual Arts. He is a member of the Nashville Public Library Foundation.

He was a co-founder of the United Way Alexis de Tocqueville Society. He also served as chair of the board of governors for United Way of America. The Dr. Thomas F. Frist Jr. Excellence in Volunteer Leadership Award of the United Way was established in 1996. In 2012, he received the United Way Lifetime Achievement Award.

Frist is President of Tomco II LLC, an aircraft company. In 2000, Scott Mercy, chairman and CEO of LifePoint Hospitals Inc. and chairman of America Service Group Inc., died in a crash. Similarly, in 2006, another aircraft belonging to Frist crashed.

He was chairman and CEO until January 2001 and chairman until January 2002. In 2006, he took private equity Investments in Bain Capital, Kohlberg Kravis Roberts and Merrill Lynch for $21 billion. He holds the record for the biggest leveraged buyout of all time and biggest PE-led IPO of all time. In 2009, he stepped down from the board of Directors, and his son, Billy Frist, joined the board. Frist was replaced as Chairman by Jack Bovender.