Couch was born in Hyden, Kentucky. As a prep quarterback at Leslie County High School in Leslie County, Kentucky, he set a number of national high school records — most pass completions (872), passing yardage (12,104), touchdown passes (132), and passing percentage for a season (75.1). Following his senior 1995 season, he was recognized as Kentucky's Mr. Football. ESPN ranked Couch as the No. 6 of the best high school athletes ever.
Couch also starred on the Leslie County High School basketball varsity team. He scored 35 points per game as a junior, which was the highest average in the state. Couch scored 3,023 points in his career, which as of April 2010 is good for the 26th highest total in Kentucky state history.
Couch attended the University of Kentucky, where he played for the Kentucky Wildcats football team from 1996 to 1998. During his 1996 freshman year under head coach Bill Curry, he split time as the starting quarterback with Billy Jack Haskins. Curry's firing was announced after a 1-6 start that season. Incoming head coach Hal Mumme announced early that Couch would be the starter in his new pass-oriented "Air Raid" offense. In 1997, Couch set several school records as the previously anemic Kentucky offense topped national offensive rankings and finished 5-6 on the season, including a win over No. 20 Alabama. During the 1998 Wildcats season, Couch led Kentucky to seven wins (including a win on the road at No. 21 LSU) and a spot in the Outback Bowl (in which Couch completed 30 of 48 passes for 336 yards and 2 touchdowns, though Kentucky lost to Penn State 26-14).
Following his junior season in 1998, Couch announced he would leave Kentucky to enter the NFL draft early.
Couch's career totals at Kentucky included completing 795 of 1,184 passes (.671 completion rate) for 8,435 yards (including 4,275 passing yards during the 1998 season alone) and 74 touchdowns (including a 97-yard touchdown pass to Craig Yeast against Florida on September 26, 1998). Couch still holds the NCAA record for completion percentage in one game (minimum of 40 completions) at 83.0% vs. Vanderbilt (44 of 53) in 1998 and for completions per game (36.4, 400 in 11 games) that same season. He also left Kentucky holding NCAA records for most completions in a season (400 in 1998), most completions in a two-year period (793 in 1997-1998), most completions per game in a two-year period (34.7, 1997–1998) and career completion percentage (67.1%). His 1998 records of 4,151 offensive yards in a season, 377.4 offensive yards per game and 4,275 passing yards, stood as Southeastern Conference records for years after his departure.
Couch's college success culminated in his selection as the number one overall selection in the NFL draft by the revived-Cleveland Browns in 1999. Couch took over for Ty Detmer as the team's starting quarterback in the second game of his rookie season. The Browns front office had high expectations for Couch. Spokesperson John Schober was quoted in 2003 as saying the former Kentucky All-American would win at least six playoff games. But Couch was joining a team that had been hastily assembled in the wake of the former Browns squad moving to Baltimore three years earlier. He spent five seasons as a starting quarterback for Cleveland, eventually facing competition from journeyman backup Kelly Holcomb during his final two seasons.
Couch's tenure in Cleveland ranged from leading the team to a playoff appearance, to boos and inconsistent play, which was partially a result of being constantly plagued by injuries. These injuries were due, in turn, to his exposure to pressure due to the expansion Browns' inexperienced offensive line. He missed the final nine games of the 2000 season with a broken thumb. The high point of Couch's career came in 2002, when he threw for 2,842 yards and 18 touchdowns in leading the upstart Browns to a 9-7 record and a playoff appearance. However, he suffered a broken leg in the final game of the regular season and was forced to watch as Holcomb threw for over 400 yards in a loss to the Pittsburgh Steelers in the Wild Card round of the playoffs. This was the beginning of a quarterback controversy in Cleveland that would not be resolved until a year later when head coach Butch Davis tapped Holcomb as his starter. By the end of the 2003 season, after exhausting both quarterbacks with the rotation, it became clear that Davis, struggling with a 5-11 football team, would never give Couch the opportunity to start again. Couch is considered by Fox Sports to be one of the NFL's biggest draft busts in its history after being taken #1 with high expectations only to falter through most of his career. However, Couch's career has also been defended by former Browns offensive coordinator Bruce Arians.
Couch had several notable moments for the Browns, including two "Hail Mary" passes. In 1999 against the New Orleans Saints, his last-second TD pass to Kevin Johnson gave the Browns their first win. Three seasons later, in Jacksonville he tossed a game-winning pass on the last play of the game to Quincy Morgan. Couch holds the distinction of being the only quarterback in NFL history to throw two game-winning passes of 50 yards or more with 0:00 left on the clock.
Magical 2002 season
The Browns' 2002 campaign was a special one. Although the 2001 Browns raised eyebrows with their defense, having recorded 43 sacks and a league-best 33 interceptions, the offense was once again moribund. The run game was pitiful and the offensive line was porous. At the start of the 2002 preseason, star linebacker Jamir Miller went down with a career-ending Achilles tendon injury. However, the reincarnated "Kardiac Kids", led by Couch, won 9 games, including five in the final two minutes and seven by 10 points or less, and made a wildcard playoff spot. Those thrillers included a 31-28 overtime win over Tennessee in which Couch threw for 326 yards and 3 TDs, a last minute TD and two-point conversion passes from Couch to Dennis Northcutt against the Jets, the "Hail Mary" against the Jaguars, and a final-minute TD drive against Baltimore where Couch threw a 1-yard strike to tight end Mark Campbell after being pinned inside his own 5-yard line with 0 timeouts and 1:30 left in regulation.
Couch is the Browns' all-time leader in pass completion percentage at 59.8%. He also ranks 7th all-time in touchdown passes (64), 6th in QB rating (75.1), 4th in passing attempts (1,741), 3rd in completions (1,025), 5th in passing yards (11,131). Couch still holds the franchise single-game record for pass completions (36 vs. Tennessee in 2002) and the rookie single-season record for passing touchdowns (15). His rookie records for pass attempts (399), pass completions (223), passing yards (2,447), and QB rating (73.2) were broken by Colt McCoy in 2010 and Brandon Weeden in 2012. He was the Browns' leading passer from 1999-2002.
After the Browns released Couch in 2004, Couch signed as a free agent with the Green Bay Packers. Couch went on to have a disappointing training camp, and was booed off the field by the Lambeau crowd during his limited preseason appearances. Couch struggled with a rotator cuff injury, that would eventually require surgery, and was sidelined for the entire year.
Couch was released by the Packers during their final cutdown to 53 players prior to the season. Couch filed a grievance with the NFL Players Union against the Packers because they failed to attempt an injury settlement prior to his release.
After undergoing shoulder surgery in February 2005, Couch auditioned for the Chicago Bears midway through the 2005 season and the Cincinnati Bengals in December 2005. The Bears observed that his arm was not back to NFL shape during their workout and did not sign him. The Bengals did not pursue Couch, although Jon Kitna was not re-signed after his contract expired in early 2006.
Couch participated in tryouts with the Tennessee Titans in January 2006. He also had workouts with the Miami Dolphins, Pittsburgh Steelers and the Houston Texans. All three teams stated that despite good workouts, they were not interested in pursuing him. Couch ended up missing the entire 2006 season due to another shoulder surgery, late June 2006.
ESPN reported on Friday, July 20, 2007, that Tim Couch had contacted all 32 NFL teams to see if any teams were interested in him for the 2007-2008 season. On July 29, 2007 Couch agreed to a two-year contract with the Jacksonville Jaguars.
Couch was brought in to compete for the 3rd string quarterback position with Quinn Gray and Lester Ricard. He played in one preseason game against the Miami Dolphins and was 2-of-4 for 11 yards. On August 18, Couch failed to make the 3rd string and was released. The next week, the Jaguars released former starter Byron Leftwich and Lester Ricard, leaving them without a 3rd string quarterback.
On August 28, 2007, Yahoo! Sports reported that Couch, while attempting to recover from a second shoulder surgery, took anabolic steroids and human growth hormone as part of his daily regimen, both banned by the NFL. Despite Couch's statements that he never took any illegal steroids, he admitted being administered HGH for about a week. Yahoo! Sports reported it had obtained documents from an anonymous source with Couch's name printed across the top that called for extensive use of drugs banned by the league. Yahoo! Sports also claimed to have received documents showing steroid prescriptions had been filled in Couch's name at a pharmacy in New York. Couch initially said he had no reservations about working with someone who endorsed the use of drugs banned by the NFL "because if I'm not doing it, I'm not really concerned. … It's no big deal to me." However, during Couch's attempted come-back with the Jaguars he put on 35 pounds of muscle and dropped his body fat to 4%. Couch also claims that he passed a drug test prior to his signing with the Jaguars. Although he was released by Jacksonville during the 2007 preseason and was not signed by any other teams, the NFL banned Couch for six games during the 2007 season for violating its drug policy.