In 1988, Rikishi, as Fatu, appeared in Texas with his tag partner Samu (as the Samoan Swat Team), working for Fritz Von Erich’s World Class Championship Wrestling. Storywise, Buddy Roberts brought them in to fight his fights against the Von Erich family and former Fabulous Freebirds partner Michael Hayes. The SST was given a big push right away; presented as an unstoppable force, they beat hometown heroes Kerry and Kevin Von Erich on August 12, 1988. They remained undefeated in WCCW until they lost to Hayes and his new partner, Steve Cox, on September 12.
On September 12, 1988, The Samoan Swat Team defeated "Hollywood" John Tatum and Jimmy Jack Funk. They made their pay-per-view debut at AWA SuperClash III, the AWA's first and last pay-per-view. In the beginning of 1989, the SST left WCCW. The Swat Team signed with WCW, introduced as manager Paul E. Dangerously’s replacement for The Midnight Express (Randy Rose and Dennis Condrey), who had left the promotion. The SST took over the Express’ feud with the newer Midnight Express (Bobby Eaton and Stan Lane), beating them at Clash of the Champions VI: Ragin' Cajun on April 2, 1989. The SST teamed with former rival Michael Hayes, Terry Gordy, and Jimmy Garvin at the 1989 Great American Bash, losing a WarGames match to The Road Warriors, The Midnight Express, and Steve Williams.
In fall 1989, Paul E. Dangerously was phased out and the SST took a new manager, "The Big Kahuna" Oliver Humperdink. They were also joined by Fatu's brother, The Samoan Savage. The SST lost more and more matches as 1989 drew to a close, but got a break when Sid Vicious was injured, leading his team, The Skyscrapers, to pull out of the "Iron Team Tournament" at Starrcade 1989. Fatu and The Samoan Savage, rebranded as The New Wild Samoans, replaced them. For the rest of their WCW career, Fatu and Savage teamed, while Samu only wrestled singles matches.
After Samu and Fatu joined the World Wrestling Federation in 1992, they were renamed The Headshrinkers, but their savage gimmick remained. The Headshrinker's first notable angle came when they interfered to help Money Inc. beat The Natural Disasters for the WWF World Tag Team Championship. Soon after, The Headshrinkers feuded with The Natural Disasters and the recently formed High Energy.
Between 1992 and early 1994, The Headshrinkers occasionally challenged for the tag title and made sporadic pay-per-view appearances, feuding with The Smoking Gunns and Men on a Mission. Fatu would receive a WWF Championship match against Bret Hart on the March 1, 1993 episode of Monday Night Raw. Despite interference by Samu, Fatu was unsuccessful.
The Headshrinkers helped Yokozuna win a casket match against The Undertaker at the 1994 Royal Rumble. In April, they turned face, took Lou Albano as their manager and challenged tag champions The Quebecers. They won the gold on the May 2 episode of Monday Night Raw. At King of the Ring on June 19, they successfully defended the title against Yokozuna and Crush. Their title reign ended at a house show in Indianapolis on August 28, when they lost to Shawn Michaels and Diesel. This happened a day before they were scheduled to defend against Irwin R. Schyster and Bam Bam Bigelow at SummerSlam. The match went on without the title, and The Headshrinkers lost by disqualification.
Soon after, Samu left the WWF to recover from injuries and was replaced by Sione (formerly The Barbarian). They were called The New Headshrinkers. The storyline reason for Samu’s departure was that he was not coping well with manager Lou Albano’s attempts to civilize him, particularly about wearing boots. The New Headshrinkers made only two pay-per-view appearances, at the 1994 Survivor Series, where they were eliminated from their ten-man tag match, but helped their team win, and at the 1995 Royal Rumble; Sione lasted about seven minutes early on and Fatu over five near the end. They entered a tournament to crown new WWF tag team champions in late 1994/early 1995, and lost to Bam Bam Bigelow and Tatanka in the semifinals. For most of 1995, they worked with Jacob and Eli Blu, usually putting them over. Their final match was a loss to Men on a Mission at a June 22 house show in London, England, after which Sione left for WCW.
Fatu became a singles wrestler in 1995. He was repackaged, dropping the savage gimmick in favor of a more realistic one. He now spoke fluent English and came from San Francisco. He spoke in vignettes of his real-life experience growing up in the ghetto and being hit in a drive-by shooting (which left him clinically dead for three minutes and with a large scar on his abdomen). He often spoke of helping the community, and the gimmick became informally known as "Make a Difference" Fatu (after his catchphrase/slogan).
In 1996, he was repackaged as The Sultan, a masked wrestler who never spoke, ostensibly because his tongue was cut out. He was managed by The Iron Sheik and Bob Backlund. He unsuccessfully challenged Rocky Maivia for the WWF Intercontinental Championship at WrestleMania 13. The Sultan vanished in 1998.
Fatu returned on the November 13, 1999 episode of WWF Metal as Rikishi Fatu, beating Julio Fantastico. "Fatu" soon became "Phatu", until he dropped the last name entirely after he started teaming with Too Cool. No mention was made of his WWF past. He had gained some weight, bleached his hair blonde, and wore a thong loincloth.
Rikishi briefly feuded with Viscera before forming a wildly popular alliance with the duo Too Cool (Grand Master Sexay and Scotty 2 Hotty). One night, during Too Cool's traditional post-match dance routine, Rikishi joined them. As the dance routines became more frequent and longer, this popularity translated to a significant push. In the 2000 Royal Rumble match, he eliminated seven opponents, and it took six wrestlers working together to eliminate him.
Rikishi also became known for his infamous signature maneuver – the Stink Face – as his smelly buttocks was rubbed onto the faces of opposing wrestlers. When his opponent was incapacitated in the corner of the ring, Rikishi would slap his buttocks to indicate the attack, and then would run in from the other side and turn around at the last second to shake his buttocks onto his victim's face.
In May 2000, fan favorites Rikishi and Too Cool feuded with Edge, Christian and Kurt Angle, culminating in a victory at Judgment Day. After winning the Intercontinental Championship from Chris Benoit on the June 22 episode of SmackDown!, Rikishi qualified for the 2000 King of the Ring tournament. On June 25, at the pay-per-view, he defeated Benoit in the quarterfinals and Val Venis in the semis. Both opponents hit him with a steel chair after losing, weakening his shoulder and helping Kurt Angle defeat him in the final. Stemming from Venis' attack, Rikishi faced him on July 6 and lost the title after Tazz hit him with a television camera. They rematched in a steel cage at Fully Loaded. In this match, Rikishi climbed the cage and, in an allusion to Jimmy Snuka, splashed Venis from the top. Rikishi soon lost the match after Tazz again hit him with a camera.
On October 9, 2000 Commissioner Mick Foley used a slip of the tongue from Scotty 2 Hotty to implicate Rikishi as the person who had run over Steve Austin almost a year earlier at Survivor Series, the night after Rikishi debuted in the WWF. Rikishi admitted it, claiming it was to allow his cousin The Rock an opportunity for stardom. Rikishi then turned heel.
Austin immediately set out for revenge, facing Rikishi in a No Holds Barred match at No Mercy. The match went to a no contest when Austin dragged Rikishi to the parking lot and tried to run him over; a police car drove in front of Austin's, saving Rikishi. Though arrested, Austin had brutally attacked Rikishi, cutting and bruising his face. Later that night, Rikishi interfered in The Rock's WWF Championship defense against Kurt Angle, but "accidentally" kicked the champ, allowing Angle to Angle Slam them both and win the title. After several attacks on Austin by an unseen assailant, it became clear that Rikishi had an accomplice. During a handicap match pitting Rikishi and Angle against Austin, Triple H came to the ring, seemingly to aid Austin, but swerved the audience by attacking him with a sledgehammer. Triple H then revealed he had masterminded the Survivor Series assault, and hired Rikishi to drive the car.
While Austin began feuding with Triple H, Rikishi's tension with The Rock boiled over. He would soon lose to him in a match at the 2000 Survivor Series. He then participated in a six-man Hell in a Cell WWF Championship match at Armageddon. Vince McMahon drove a flatbed truck ringside in an effort to dismantle the cage and stop the match. Before he could, The Undertaker chokeslammed Rikishi from the top of the cell onto the wood chip-covered bed. Angle later retained the title.
In January 2001, Rikishi won a Fatal Four Way match on SmackDown for the #30 spot in the 2001 Royal Rumble match involving Rock, Undertaker and Kane, after he pinned this latter. There, he eliminated The Undertaker, and was soon eliminated by The Rock. Haku returned to the WWF in the Rumble, and he and Rikishi formed a tag team and feuded with The Brothers of Destruction, The Dudley Boyz then The Hardy Boyz. The team split while Rikishi was sidelined with an eardrum injury in March. He returned on the May 3 SmackDown and fought The Undertaker to no-contest. On the next Raw, he turned face and gave the Stink Face to Stephanie McMahon after she distracted him, and cost him a non-title match with Austin. On May 20, at Judgment Day, he injured his shoulder in the opening bout with William Regal, which caused him to miss much of the year and the entire Invasion angle.
Rikishi returned on December 6, 2001, delivering a Stink Face to Vince McMahon and solidifying his face status. Upon the WWE Brand Extension, Rikishi was drafted to SmackDown!. At Judgment Day, he faced Billy and Chuck in a "secret partner" match. His partner turned out to be Rico, Billy and Chuck's stylist. Despite Rico's best efforts to unfairly help Billy and Chuck, Rikishi and he won the match and became the Tag Team Champions. Rico would later cause his partner to lose the titles in a rematch.
Rikishi was not featured much in late 2002 and early 2003. He feuded with John Cena, Bill DeMott, and The Full Blooded Italians on SmackDown!. The return of Roddy Piper led Rikishi to challenge him as Piper had hit Jimmy Snuka with a coconut years ago on Piper's Pit. At Backlash 2003, Piper's protege Sean O'Haire defeated Rikishi after Piper got hit with a coconut by Rikishi, giving O'Haire time to hit the Widowmaker on Rikishi. Rikishi eventually formed a tag team with Scotty 2 Hotty, and the duo defeated the Basham Brothers for the WWE Tag Team Championship on February 5, 2004, holding them for two and a half months before losing them to Charlie Haas and Rico. Rikishi, however, was released by WWE on July 16, 2004.
Rikishi appeared with his family at the 2012 WWE Hall of Fame ceremony to induct his cousin Yokozuna. He then made an in-ring appearance on Raw on July 16, 2012, defeating Heath Slater. After the match, he danced with his sons Jimmy Uso and Jey Uso. He then reappeared on the 1,000th episode on July 23 with other legends to help Lita take down Slater.
Rikishi next appeared on the January 6, 2014 episode of Raw, where he reunited with Too Cool to defeat 3MB in a six-man tag team match.
On the February 9, 2015 episode of Raw, Rikishi was announced as the newest member to be inducted into the WWE Hall of Fame Class of 2015. His sons Jimmy and Jey Uso inducted him into the Hall of Fame on March 28, 2015.
Rikishi appeared on WWE for the Raw Reunion show on July 22, 2019.