After his college career, the 6'10", 244 lb power forward was selected 3rd overall in the 1988 NBA draft by the Philadelphia 76ers but immediately traded to the Los Angeles Clippers. After four years with the Clippers where he was among the team's top scorers and rebounders, he was traded to the New York Knicks with Doc Rivers and Bo Kimble for point guardMark Jackson. Smith was expected to fill the hole at small forward left by Xavier McDaniel after the Knicks failed to re-sign him after their successful 1991–92 season, a role that Smith struggled in as he was primarily a power forward, and his knees became more problematic around this time. As Smith's stats declined, he was traded to the San Antonio Spurs for J. R. Reid before retiring in 1997 due to severe injuries. As a Knick, Smith is infamous for being blocked 4 straight times very near the basket, despite a height advantage, as he attempted to give New York the lead in Game 5 of the 1993 Eastern Conference Finals against the Chicago Bulls. After taking a 2–0 series lead, the Knicks lost Games 3 & 4 in Chicago Stadium. With a chance to take a 3–2 series lead at Madison Square Garden, Smith's attempts were hampered by Michael Jordan, Horace Grant and Scottie Pippen in the final seconds, becoming one of the most notorious and disappointing moments in Knicks history. The Knicks then lost Game 6 and the series in Chicago to complete an epic collapse, while the Bulls moved on to defeat the Phoenix Suns in the NBA Finals and win their third consecutive championship. However, he was with the Knicks the following year when they defeated the Bulls in the second round, but lost in the NBA Finals to the Houston Rockets. Smith averaged 14.4 points and 5.8 rebounds during his career.
Post-retirement
In 1989, Smith founded the Charles D. Smith Foundation and Educational Center, in which the building was the first City Hall in the Northeast, and was later converted into a library. The after school center was created for inner-city school children from kindergarten to 9th grades to improve academics and offer a place for youth to get off the streets. Located in Smith's hometown of Bridgeport, it was his dream since playing at Pitt to operate the center that still stands today. Smith ran a digital media company, based in Manhattan for about 6 years. Smith was also a motivational speaker. Smith was once a regional representative for the NBA Players Association. In 2008, Smith became the executive director of the National Basketball Retired Players Association. Smith started a transition assistance program to help retired players pursue new careers. Smith was dismissed from the NBRPA in 2010 which the players felt was necessary. The $28,000 given to Smith by NBRPA head, Billy Hunter, for Smith's legal fees was from contributions used to help support retired players. ESPN caught wind of the misuse of the funds and Smith had to return the money. He started reaching out to members to start his own rival group and was threatened with a lawsuit by NBARPA. He established the Pro Basketball Alumni Association which became infamous for joining Dennis Rodman in North Korea in 2014. Smith traveled to North Korea in January 2014 with Dennis Rodman to further Rodman's "Basketball Diplomacy" effort with North Korea leader Kim Jong Un.