Scott served in the U.S. Navy and then went into business. He earned a business degree and law degree and joined a Dallas firm where he became partner. In 1987 he helped found the Columbia Hospital Corporation with two business partners; this merged with Hospital Corporation of America in 1989 to form Columbia/HCA and eventually became the largest private for-profit health care company in the U.S. He was forced to resign as Chief Executive of Columbia/HCA in 1997 amid a scandal over the company's business and Medicare billing practices; the company ultimately admitted to fourteen felonies and agreed to pay the federal government over $600 million. Scott later became a venture capitalist, and entered into politics in 2010, when he announced his intention to run for Governor of Florida.
Having defeated Bill McCollum in the Republican primary election, Scott defeated Democrat Alex Sink in a close race in the 2010 Florida gubernatorial election.