After a collegiate career at the University of Alabama, Al signed with the Cubs in 1951. The following year he was dealt to the Giants, where he made an auspicious debut in 1953. The righthander tossed shutouts in each of his first two major league games before falling off and finishing at 4-8 with a still-strong 3.44 ERA. He spent much of the next two years back in the minors, collecting 19 wins at Minneapolis in 1955. Upon his return to New York in 1956, he suffered from poor run support: 7-14 with a near-league-average 3.97 ERA. Beginning in 1957, Al was used primarily in relief, and he won a career-best 11 games in 1958. After spending parts of six seasons as a Giant, he was traded twice in 196o, traveling from the Giants to the Red Sox to the White Sox.
In all, Worthington would pitch just ten games in the majors in 1960, and would not get another crack at big league hitters until 1963, after the Reds had drafted the then-34-year-old from Chicago's organization. He saved 10 games with a 2.99 ERA that year, a precursor to his rebirth as one of the first modern closers. After being sent to Minnesota in mid-1964, Red led the Twins in saves for five years running. He peaked in 1965 with 10 wins, 21 saves, and a 2.13 ERA for the American League champs; he would add four scoreless innings in the team's seven-game World Series loss to the Dodgers. As a last hurrah, Al led the league in saves with 18 in 1968. The next year would be his last, as he was supplanted in the closer's role by Ron Perranoski. Al Worthington's final appearance was in middle relief in Game 3 of the 1969 ALCS; he pitched a 1-2-3 fifth inning before getting chased by three straight Oriole hits in the sixth.
Worthington returned to the Twins as a coach in 1972-1973. He spent the next thirteen years as head coach at Liberty University in Lynchburg, Virginia.
Fun fact: After throwing two shutouts in his first two career games, Al had just one more shutout in his next 600 games (67 starts). On August 18, 1957 he three-hit the Phillies, winning 1-0 on an RBI double by Bobby Thomson.