Hurst was selected by the Bosox with the 22nd overall pick in the 1976 Major League Baseball Draft out of Dixie High School in St. George, Utah. After going 17-6 with a 2.88 earned run average for the Winter Haven & Bristol Red Sox in 1979, Hurst was put on Boston's opening day roster for 1980. He made his major league debut in relief in the second game of the season, giving up five earned runs in an inning of work in a 18-1 blowout at the hands of the Milwaukee Brewers  He made six more appearances, all starts, before being optioned back to Pawtucket with a 10.57 ERA. He returned to the majors in August, ending the season with a 2-2 record and 9.10 ERA at the major league level. 

Consistently good but never overpowering, Bruce Hurst used an array of pitches to keep righthanded sluggers at bay. The southpaw may not have been the natural athlete that his longtime teammate Roger Clemens was, but he turned to sneaky fastballs, knee-buckling forkballs, and changeups to play mind games with his opponents. Hurst was a rare lefthander who excelled at Fenway Park. He was 33-9 there from 1986 to 1988, and his 56 Fenway wins are second only to Mel Parnell's among southpaws. His pickoff move to first base was a weapon as well -- he caught 15 baserunners in 1984.

Hurst went 12-7 with a 2.87 ERA for Pawtucket in 1981, and had actually retired from the game briefly before receiving a September call-up to Boston. While pitching for the 1981 Pawtucket Red Sox, Bruce Hurst appeared in the longest game in baseball history, pitching 5 shutout innings (allowing 2 hits) as the 7th PawSox hurler. Bruce Hurst made his debut with the Boston Red Sox in 1980. In five major league starts, Hurst went 2-0 with a 4.30 ERA.

Hurst had gone 42-46 with a 4.59 ERA with the Bosox before his breakthrough 1986 season. Despite spending six midsummer weeks on the disabled list with a pulled groin in 1986, Hurst posted a 2.99 ERA and helped lead the Red Sox to the 1986 World Series. Hurst posted 13 victories despite spending six midsummer weeks on the disabled list with a pulled groin. The Red Sox won the American League East by 5.5 games over the New York Yankees to head to the 1986 American League Championship Series against the California Angels. He went 1-0 with a 2.40 ERA in two starts in the American League Championship Series won by the Sox in seven games. In the Fall Classic he baffled the Mets, winning Game One 1-0 and Game Four 4-2, prompting Darryl Strawberry to remark, "Clemens is tough, but he's no Hurst." He had been voted the Series MVP before the Mets rallied to win Game Six with three runs in the bottom of the 10th, and the award was given to Ray Knight when the Mets won Game Seven as well.  Oil Can Boyd was originally slated to be the Game Seven starter for Boston, but when the game was delayed a day by rain, manager John McNamara bumped him in favor of Hurst. Hurst gave up just one hit through five innings of work, however, the Mets came back with three runs in the sixth to tie the game. Hurst would get a no-decision as he handed the ball over to the bullpen. The Mets won the World Championship, and Ray Knight received MVP honors. 

Hurst was 9-4 with a 4.60 ERA midway through the 1988 season when the Red Sox replaced McNamara at manager with Joe Morgan. The Sox were in fifth place, nine games back of the first place Detroit Tigers at the time of the managerial change. The team went 46-31 from that point forward to finish one game ahead of Detroit in the AL East.  Hurst himself went 9-2 with a 2.54 ERA under his new manager to end the season at 18-6. He pitched a complete game in Games One of the 1988 American League Championship Series against the Oakland Athletics, but was outmatched by Oakland's ace, Dave Stewart.  With Boston down three games to none, the two faced off again in Game Four with Stewart and the A's again emerging victorious to complete the sweep.

In 1988, Hurst became baseball's most coveted free agent after a career-best 18-6 record, and he accepted less money from the San Diego Padres than the Red Sox had offered so he could pitch in San Diego, closer to his Utah roots. He went 15-11 with a career-best 2.69 ERA in 1989.

Hurst pitched well with the Pods for four years, going 55-37 and establishing himself as a top-notch lefty. At the end of 1992, Hurst began to feel pain in his left shoulder, and underwent surgery that October to repair a torn rotator cuff and labrum. The rehabilitation was an arduous process, and he ended up going on and off the DL for the entire 1993 season, pitching only 13 innings. Half of those innings came for the Colorado Rockies, to whom he was traded in July along with Greg W. Harris for Brad Ausmus, Doug Bochtler, and Andy Ashby.  At the end of the season, Hurst signed on with the Texas Rangers, hoping to leave his injuries in the National League. But halfway through the year, with repercussions of the surgery still lingering, the southpaw was forced to pitch through pain each time he trudged to the mound. When he realized his shoulder wasn't getting any stronger, Hurst retired in June 1994, stating that he didn't want to be a detriment to his team.

Bruce Hurst was inducted to the Boston Red Sox Hall of Fame in November 2004.