He has created musical groups including the Butch Thompson Trio and New Orleans Jazz Originals. Thompson gained a wide audience as the pianist and bandleader for A Prairie Home Companion from 1974 to 1986. The Butch Thompson Trio was formed for the radio show in 1978, and continues to perform today. Thompson and his group maintain a close relationship with the radio program and appear regularly.
In the 1970s, Thompson's recordings gained popularity in Europe. He toured the continent extensively in the 1970s and 1980s, both as a solo artist and as a band leader or member. Thompson has written for jazz publications and produces a radio show, Jazz Originals, for KBEM-FM in Minneapolis.