In addition to teaching, Kiki Smith is also a professional costume and set designer. She designs for regional theaters and choreographers, including the Talking Band in New York and Shakespeare & Co. in Lenox, Massachusetts, where she is a founding member.

Smith won a Village Voice OBIE award for her designs for the Talking Band's 2003 premiere of Ellen Maddow's A Painted Snake in a Painted Chair, directed by her colleague Paul Zimet. She earned an A.B. from Smith College in 1971 and has a master's from the University of Virginia and a master's of fine arts in theater design from the University of Texas.

Smith teaches two levels of costume design, supervises student designers and oversees the Smith College Historic Clothing Collection. Other special topics courses she has offered include Design for the Dance, Twentieth Century Fashion Designers, and Making Theatre Illusion with Costume Construction, Masks and Makeup.