A hard-throwing reliever, Worrell emerged in late August 1985 as the Cardinals' closer, after the loss of Bruce Sutter to free agency. Worrell saved five games down the stretch and compiled an earned run average of 2.91, then pitched effectively in the postseason against the Dodgers in the NLCS and the Kansas City Royals in the 1985 World Series. He was still eligible as a rookie the following season, and his 9-10 record with 36 saves netted him the 1986 National League Rookie of the Year Award, as well as the National League Rolaids Relief Man Award. He was on the mound when winning run in Game 7 of the 1987 World Series scored, though he was not tagged with the loss as the runner who scored it had been inherited from another pitcher. Worrell became the first relief pitcher to save 30 or more games in each of his first three full seasons.
On September 4, 1989, Worrell was pitching for his 125th career save, which would have tied him with Sutter for the Cardinals' career record. While making a pitch, he felt a ligament snap. He underwent elbow surgery in December to repair the damage, then experienced shoulder pain when attempting to come back for the 1991 season and was diagnosed with a rotator cuff tear. As a result, he missed both the 1990 and 1991 seasons due to injuries and rehabilitation.
Worrell came back in 1992 as a set-up man for veteran Lee Smith. At the end of the season he signed as a free agent with the Dodgers, where he struggled for two seasons before regaining his old form and saving 32, 44, and 35 games in the final three seasons of his career and making two of his three career All-Star appearances.
Josh and Jeremy Worrell have followed in their father's footsteps as baseball players. Both of them played collegiately at Indiana Wesleyan University in Marion, Indiana. Jacob Worrell, the youngest of the three, is at Indiana Wesleyan. He is also trying to follow in his father's footsteps. Josh Worrell was drafted in the 30th round of the 2009 MLB draft by the Kansas City Royals. Todd is currently the pitching coach at Westminster Christian Academy in St. Louis.