Cincinnati, while having a rich history, had fallen on hard times. Cincinnati appeared in 5 consecutive Final Fours from 1959 to 1963—and won the national championship in 1961 and 1962. By 1989, when Huggins was hired, though, the Bearcats had not earned a bid to the NCAA tournament since 1977. Even worse, Cincinnati had only one winning conference record in those 12 previous seasons. The Bearcats were invited to the NIT his first two years and then advanced all the way to the Final Four of the NCAA tournament in 1992, Huggins’ third season as coach.

Huggins began his coaching career as a graduate assistant at West Virginia under Gardner in 1977. He then spent two years as an assistant to Eldon Miller at Ohio State University. Huggins was only 27 when he became a collegiate head coach at Walsh University in 1980. In three seasons at Walsh, he compiled a 71–26 record, twice earning NAIA District 22 Coach of the Year honors. Huggins directed the Walsh 1982–83 team to a perfect 30–0 regular season mark and an eventual 34–1 mark. After serving as an assistant at University of Central Florida for the 1983–84 season, Huggins was named head coach of the University of Akron. Huggins compiled a 97–46 record and reached post-season play in three of his five seasons at Akron, including an NCAA bid in 1985–86 season.

Overall, Huggins compiled a 399–127 record (.759) in his 16 years at Cincinnati, making him the winningest basketball coach in the school’s history. Huggins directed Cincinnati to ten conference regular-season titles and eight league tournament titles. The Bearcats appeared in post-season play in each of Huggins’ 16 seasons. Besides the aforementioned Final Four appearance in 1992, they advanced to the Elite Eight of the NCAA tournament two other times, in 1993 and 1996.

Huggins earned the Ray Meyer Award as the Conference USA Coach of the Year a record three times (1997–98, 1998–99, and 1999–2000), and was a unanimous choice for C-USA Coach of the Decade. He was selected national coach of the year by ESPN.com in 2001–02. His teams won five consecutive conference tournament titles—all four Great Midwest Conference titles from 1992 to 1995 and the first Conference USA Men’s Basketball Tournament in 1996. He was named co-national coach of the year by The Sporting News and was Basketball Times’ national coach of the year in 1997–98. He earned national coach of the year recognition from Hoop Scoop in 1991–92 and Playboy in 1992–93.

Zimpher said that the Bearcat program under Huggins didn’t fit with her plan to upgrade UC’s academic reputation. However, she’d been seriously considering ousting Huggins since he was arrested for driving under the influence in 2004. He ultimately pleaded no contest to DUI.

At the time, Huggins’ contract had a rollover clause which added a year every summer. Zimpher revoked that clause on June 11, 2004 after his no-contest plea, but allowed Huggins to return for the 2004–05 basketball season. On May 11, 2005, he was given the option of leaving or finishing the last two years remaining on his contract. In a May 16, 2005 press conference, Huggins announced that he was staying until his contract expired on June 30, 2007, thus agreeing to the terms originally offered to him by UC.

On August 23, 2005, UC President Nancy L. Zimpher gave Huggins an ultimatum: resign and take a $3 million buyout, or be reassigned outside the athletic department for the balance of his contract. Had Huggins not responded within 24 hours, he would have been fired. Huggins had untruthfully told the press he didn’t know about the ultimatum until numerous reporters called him in Las Vegas. However, multiple correspondence between UC and Huggins’ attorney showed that not only had the parties been negotiating his termination, Huggins knew weeks in advance his termination was imminent. He ultimately agreed to accept the $3 million buyout.

After spending a year out of the coaching profession, on March 23, 2006, Huggins accepted the head coaching job at Kansas State University, replacing the fired Jim Wooldridge. The Wildcats had not been to the NCAA tournament since the 1995–1996 campaign and had not had a conference record better than 7–9 since the Big 12 Conference was formed in 1996. The previous three Kansas State basketball coaches (Dana Altman, Tom Asbury, and Wooldridge) had combined for a 236–232 (.504) record. In his sole season at Kansas State, Huggins coached the Wildcats to a 23–12 overall record, and a 10–6 Big 12 record. the Wildcats also advanced to the second round of the NIT in the postseason.

Some of Huggins’ recruiting targets included consensus top 10 players in O. J. Mayo, Bill Walker, as well as consensus top 100 recruits such as Herb Pope, Ramar Smith, and Jason Bennett. While Mayo, Pope, and Smith all ended up at other schools, Huggins was able to bring in Bennett for the 2006–07 season and Walker—initially slated to join the team for the 2007–08 season, managed to graduate from North College Hill High School early to participate in time for the spring semester. Huggins’ second recruiting class was rated even better. The key recruit was consensus top 5 player Michael Beasley out of the Washington, D.C. area. Other recruits in the 2007 class included Walker, Dominique Sutton—a 6’4″ swingman out of Durham, North Carolina–Jacob Pullen—a 6’1″ point guard from Proviso East High School— and Fred Brown, a 6’2″ shooting guard from West Palm Beach, Florida.

On April 5, 2007, Huggins announced that he had accepted the position of head coach at his alma mater, West Virginia University. Coach Huggins succeeded John Beilein who left to fill the same position with the Michigan Wolverines. Only nine games into the 2007–2008 season, the Mountaineers entered the AP Top 25 poll carrying a #24 ranking with an 8–1 record. On December 22, 2007 Huggins achieved his 600th victory as a head coach in a road game at Canisius.

West Virginia earned a first round bye in the 2009 Big East Tournament, and opened the second round of play with a 74–62 victory over Notre Dame. In the quarterfinals round, West Virginia defeated #2 Pittsburgh 74–60, but lost to Syracuse in overtime 74–69. Syracuse was fresh off the heels of a six overtime victory against Connecticut, the longest game in Big East history. WVU earned a #6 seed in the NCAA tournament and played their first-round game against the #11 seed Dayton Flyers. The season ended with a 68–60 loss to the Flyers.

On April 3, 2010, Duke, the #1 seed from the South and the Mountaineers, squared off in the second of the Final Four games. Duke showed its full potential in the game, hitting 52.7 percent of its shots (and 52 percent of its three-pointers) while shredding West Virginia’s 1–3–1 zone trap. Duke led 39–31 at the half and maintained its red-hot shooting in the second half. After WVU lost star forward Da’Sean Butler, a Wooden award finalist, to a devastating knee injury, the defining play of the game came when Nolan Smith missed a contested, fast-break layup, but Kyle Singler and Miles Plumlee combined to slam home the rebound to give Duke a 14-point lead. Despite the Final Four loss, WVU finished their season with a 31–7 record, and ranked #3 in the final Coaches’ Poll, and #6 in the AP Poll.

On December 22, 2011, Huggins reached his 700th career victory by defeating Missouri State, making him one of 4 active coaches in Division I college basketball to have earned more than 700 wins.

In the 2016 NCAA Tournament, West Virginia was awarded a 3 seed, but its stay was short-lived as the 14th seeded Stephen F. Austin Lumberjacks knocked them off in the first round.