The younger son of Henry Smith, professor of systematic surgery, when Sir Joseph (afterwards Lord) Lister was professor of clinical surgery, at King's College, London. Hugh Smith was educated at King's College, of which he was afterwards an Associate, and at King's College Hospital, where he was house surgeon and surgical registrar. He then studied in Paris, and became house physician at the Brompton Hospital for Consumption and registrar at the Victoria Hospital for Children, Tite Street, Chelsea. He was also for a short time medical officer to the Stanhope Street Dispensary. He entered into partnership with William Robert Ashurst, MD, at Farningham, Kent, and later with William Francis Lace. For thirteen years he acted as medical officer of health for the Dartford Union and served as medical officer of No 3 District of the Dartford Union, Kent. He was also surgeon to the Kettlewell Convalescent Home, Swanley, and to the Parkwood Convalescent Homes. He was chairman of the Dartford division of the British Medical Association. He died after retirement at Wilmington Cottage, Seaford, Sussex on 20 November 1930. Endowed with the bonhomie and wit of his father, he entirely lacked ambition and was content to go through life in a useful but comparatively humble position.