In 1981, Chow began gymnastics training and began competing in national and international competitions in 1990. She is primarily known for her performance at the 1996 Olympics where she won a silver medal on the uneven bars and a team gold.

Chow also competed in the 2000 Summer Olympics. She qualified to the all-around finals where she was the second-ranked American woman, finishing in fourteenth place.

Chow has two gymnastic moves named after her, the "Chow/Khorkina" and the "Chow II." She was nicknamed "the Trickster" for her extreme difficulty on each apparatus and her ability to perform complicated skills with apparent ease. She was the first American woman to perform both the double-twisting Yurchenko and the tucked double-double dismount on bars in international competition. Chow also competed one of the most difficult balance beam routines ever performed. She is a member of the famous Magnificent 7 who were the first American team to win Olympic gymnastics gold.

In addition to her gymnastic career, Chow is also a pianist. In 1994, she received an advanced level certificate of merit for piano. In 2006 she graduated medical school at Stanford University, having earned an undergraduate degree in biology from Stanford in 2002.

In 2008, Chow was inducted into the Olympic Hall of Fame in the team category, alongside the rest of the Magnificent Seven. The team received their award in Chicago with other Olympic greats.