Despite this, she did not start recording till 1923 on Columbia records. These recordings, including the million-selling "Down Hearted Blues", made her one of the foremost singers of the 1920s and featured such musicians Louis Armstrong, Joe Smith, Clarence Williams, Benny Goodman, and Fletcher Henderson. She had numerous hits over the decade, including the songs most associated with her, such as "Nobody Knows You When You're Down And Out". They sold well for most of that decade, but by 1929 a sequence of bad personal and business decisions, coupled with her heavy drinking and had left her broke, and without a recording contract.
A role singing the title song in the movie St. Louis Blues notwithstanding, Smith now found work hard to come by until 1933 when John Hammond rediscovered Smith, supposedly singing bawdy songs as part of a burlesque show, and invited her to a recording session, again with Columbia, (which was to be her last). Perhaps unsurprisingly, the lyrical style of these last sides was explicit, exemplified by the suggestive nature of "Take Me For A Buggy Ride" and "Need A Little Sugar In My Bowl", but not that far from the "Empty Bed" and "You've Been a Good Old Wagon" of her most successful period.
She resumed touring with some success, adding swing to her repertoire, and continued until her death in a road accident while travelling from a concert in Memphis to Clarksdale, Mississippi along United States Highway 61. She was in a car driven by her companion (and Lionel Hampton's uncle) Richard Morgan. They were in an accident and Smith was severely injured. A doctor soon arrived at the scene and summoned an ambulance. She was taken to a colored hospital in Clarksdale and her arm was amputated. However, she had lost a lot of blood and she died later that day. She was 43 years old.
At the time of her death, John Hammond wrote in Down Beat magazine that she might have died because she was initially refused entrance to a white hospital and her treatment was delayed while she was take to a black hospital. Hammond later recanted his story.
Despite knowing of this recantation, playwright Edward Albee wrote "The Death of Bessie Smith", which fixed the story in the public mind.
A more recent play featuring 14 of the songs Smith made famous, The Devil's Music: The Life and Blues of Bessie Smith by Angelo Parra, was named one of the "top-10 Off-Broadway experiences" of 2001 by the New York Daily News.
Smith's style was, and remains, highly influential, especially on the young Billie Holiday, gospel singer Mahalia Jackson and Janis Joplin, who idolised the older woman. Joplin led a fund-raising effort to put a stone on her grave. She provided an important transitional link between the "blues shouters" of Rainey's generation and the jazz that followed.