Lake first appeared to audiences when she played the hefty Tracy Turnblad, the main character of the John Waters film Hairspray. Her role as the overweight Red Cross recreation worker "Holly the Donut Dolly" in the television series China Beach gave her additional visibility, and she was eventually chosen to host the eponymous talk show. At the same time, she publically went on a weight loss regime, and wound up losing about 125 pounds (57 kg).

Ricki Lake debuted on 13 September 1993. While it avoided the worst excesses of The Jerry Springer Show, it was not especially serious in tone either. A typical show might present several lower middle class women, each claiming to be "All that" (the show's catchphrase for someone with high fashion and personal appeal) with others debating the assertion. Other shows would present someone in an obviously bad relationship and have Lake recommend, "Dump that zero and get yoself a hero." Once Lake became a mother, feel-good mother-and-child shows became common.

The talk show has often been the butt of satire, and it was repeatedly parodied during the 1990s on Saturday Night Live, with male cast member Jay Mohr impersonating Lake in drag. The show was also parodied fleetingly on Family Guy (the guest on the show was quoted to have said, "Yo, Ricki, that's my girlfriend. She ain't supposed to be havin' no penis!"). It was also mentioned in the chorus of the hit 1998 song "Pretty Fly (for a White Guy)" by The Offspring: "So if you don't rate, just overcompensate, at least you know you can always go on Ricki Lake."

Faced with declining ratings, Lake decided after 11 seasons she would end her show. She was in talks to star in an untitled CBS comedy, but after the pilot was shot it wasn't picked up. Most recently, she has appeared in a recurring role on CBS's long-running sitcom The King of Queens, playing Doug Heffernan's sister, Stephanie.

Lake has also appeared in the films Serial Mom, Cookie, Cry-Baby, Mrs. Winterbourne, and Inside Monkey Zetterland, and she often appears in small roles in John Waters films, such as Cecil B. Demented.

Lake married husband Rob Sussman on 26 March 1994; as she described in a television interview, their attraction had been immediate: "Within an hour and a half of first meeting, we were tearing each others' clothes off." However, time passed, and she filed for separation in August 2003. Lake won the first legal round when the judge ruled that the prenuptial agreement signed by the two was valid. Lake and Sussman together have one son, Milo Sussman, born in 1996.

There was talk that Lake is crafting a talk-show comeback, according to Broadcasting & Cable magazine. Rumors suggested the new show, which would have been somewhat similar to her old show, yet somewhat more mature, might have launched as early as September 2006. A source close to the deal, said that, by October 2005, it wouldn't be surprising if a deal was reached. There has been no more developments released publicly on any sort of deal, and Ricki wasn't at NATPE 2006, which diminishes the likelihood of any such show airing in Fall 2006. An associate producer from The Ricki Lake Show stated that Sony Pictures Television/Columbia TriStar, the company that syndicated her previous show, is not involved. Sources say other companies, including TelePictures, which syndicated Jenny Jones' show, are.

Ricki Lake has been named as the host of CBS' Game Show Marathon, which will re-create classic game shows with celebrity contestants. The series is set to air in 2006. She also inked a development deal with Game Show Marathon creator FremantleMedia for other ventures, including creating and producing future programs and projects.

In a segment in which listeners of Jim Rome's radio show send humerous e-mails claiming to be various celebrities, Lake is a frequent target (i.e. "Dear Jim, I don't see a problem with drinking gravy to quench my thirst. Sincerely, Ricky Lake").