Smith represented the United States in the women's 100 metre freestyle S3 event and won a silver medal at the 2020 Summer Paralympics.[2]
On April 14, 2022, Smith was named to the roster to represent the United States at the 2022 World Para Swimming Championships.[3] At the World Championships, she won a gold medal in all seven events she participated in, to lead all swimmers in gold medals. Her seven gold medals were the most in a single championships by an American since Jessica Long also won seven gold medals in 2010.[4]
Following the 2022 World Para Championships, she fell ill with a respiratory infection. As a result, she spent several weeks in the hospital with a partially collapsed lung, including time in the intensive care unit. During this time she had to relearn how to eat, speak, swallow and swim.[5] After extensive rehab on April 29, 2023, Smith was named to the roster to represent the United States at the 2023 World Para Swimming Championships. During the event she won a bronze medal in the 200 metre freestyle S3 event.[6]
She competed at the 2025 World Para Swimming Championships and tied Katie Kubiak as team USA's most decorated swimmer at the event with seven medals. She won three gold medals, two silver medals and two bronze medals.[7]
