Professor O'Rourke has been a member of the teaching and research staffs at Cornell University and the University of Illinois at Urbana-Champaign. His teaching and professional practice include geotechnical engineering for earth retention systems, foundations, and soil structure interaction; earthquake engineering; underground construction technology, and engineering of large, geographically distributed systems such as water supplies, gas and liquid fuel systems, electric power, and transportation facilities. He has authored or co-authored over 325 publications on geotechnical, underground, earthquake engineering, and impact of extreme events on civil infrastructure networks.

He is an elected member of the US National Academy of Engineering (1993) and a Fellow of the American Association for the Advancement of Science (2000). He was awarded the CA. Hogentogler Award from ASTM in 1976 for his work on the field monitoring of large construction projects. In 1983 and 1988, Prof. O'Rourke received the Collingwood and Huber Research Prize, respectively, from ASCE for his studies of soil and rock mechanics applied to underground works and excavation technologies. In 1995 he received the C. Martin Duke Award from ASCE for his contributions to lifeline earthquake engineering, and  in 1997 he received the Stephen D. Bechtel Pipeline Engineering Award from ASCE for his contributions to pipeline engineering. In 2002 he received the Trevithick Prize from the British Institution of Civil Engineers and was designated as an NSF Distinguished Lecturer. He received the 2003 Japan Gas Association Best Paper Award and the1996 EERI Outstanding Paper Award. In 2005 he received the Ralph B. Peck Award from ASCE. He has been named to give the 2009 Rankine Lecture in London, UK, sponsored by the British Geotechnical Association. He received both the College of Engineering Distinguished Service Award (2005) and the CEE Distinguished Alumnus Award (2000) from the University of Illinois. In 1998 and 2003, Prof. O'Rourke received Cornell University's College of Engineering Daniel Lazar and Kenneth Goldman Excellence in Teaching Awards, respectively. He holds a US patent for innovative pipeline design, with patent pending for a remote environmental monitoring system.