Having moved with his family to Los Angeles in 1942, Ailey became involved with the Lester Horton Dance Theater there in 1949. Following Horton's death in 1953, Ailey was director of the company until it disbanded in 1954. He moved to New York City that year. There he performed in various stage productions and studied acting with Stella Adler and dance with Martha Graham, Hanya Holm, Charles Weidman, and others.

In 1958 Ailey formed his own dance company. The Alvin Ailey American Dance Theater, composed primarily of blacks, toured extensively both in the United States and abroad. In addition to works by Ailey, the company performed the works of several pioneer choreographers of modern dance, including Horton, Pearl Primus (Primus, Pearl), and Katherine Dunham (Dunham, Katherine). The company's signature piece is Revelations (1960), a powerful, early work by Ailey that is set to African American spirituals.

Ailey subsequently continued to choreograph works for his own and other modern-dance companies. The Alvin Ailey American Dance Theater, through its highly successful tours on every continent, made him the best-known American choreographer abroad from the 1960s through the '80s.