Not much is known about Smith, including why he came to start killing, though he was mentioned to be a sexual sadist. He killed a total of eight Alabama prostitutes from 1967 to 1987, by hammering icepicks into the back of their necks, starting with Patricia "Patty" Johnson, who was killed on October 9, 1967, when Smith was twenty years old. Also, during this time period, he somehow acquired a prominent scar on his jaw. He was also arrested for an unspecified reason (likely related to the incident in which he acquired his scar) on August 3, 1977, days before killing his fourth victim Marsha Allen, but was released. His killings ended on January 19, 1988, when he got into a gunfight with Tuscaloosa police officers, during which he was severely wounded. Smith was rushed to a local hospital, where he died from his gunshot wounds. At the same time, in the same hospital, and even alongside Smith's dying body, Willie Kestler was born. This coincidence would motivate Kestler to commit his own killings.
Smith was frequently mentioned throughout the episode, and also appeared in Kestler's flashback about his birth. Afterwards, Kestler assumed Smith's identity as his own.
Smith targeted prostitutes who were aged in their late teens to early 20s. He would ambush them in outside places and threaten them into compliance with a handgun. His signature was forcing them to lie down on the ground, making them bite down on a block of wood, and killing them by hammering an icepick down into the back of their necks using a large hammer.
- October 9, 1967, Mobile: Patricia "Patty" Johnson
- December 10, 1970, unspecified location: Lori Silva
- June 21, 1974, unspecified location: Tina Cavallini
- August 14, 1977, unspecified location: Marsha Allen
- March 28, 1979, Gadsden: Carol Hansen
- September 30, 1983, unspecified location: Cynthia Powell
- February 5, 1985, Birmingham: Taylor Lynn Grover
- November 2, 1987, unspecified location: Josie Hardin
- January 19, 1988, Tuscaloosa: Several unnamed police officers (attempted; got into a gunfight with them)
- Smith has some similarities to Season Three serial killer Francis Goehring. Both were sexual sadists who targeted women, acquired scars on their cheeks, and died after confrontations with police officers. Their deaths also inspired a copycat to emerge.
- Smith also has some similarities to Season Seven serial killer Rodney Garrett, who also targeted women and killed them using an icepick. Their deaths also inspired a spree of copycat killings.