On 27th June 2000 Norwich City appointed ex Northern Ireland captain Nigel Worthington as Joint Assistant Manager. The aim was that he would share the role with first team coach Doug Livermore. Worthington's most recent role had been as assistant manager to the England under-21 squad, a job for which he was selected by Football Association technical director Howard Wilkinson.

Prior to that Worthington was manager at Division Two side Blackpool and as a player he represented Notts County, Sheffield Wednesday (for twhom he made 400appearances in 10 years), Leeds and Stoke City. He won 66 caps at left back for Northern Ireland and was made captain of his country by then manager Bryan Hamilton

Nigel was appointed as Assistant Manager to the Northern Ireland Under 21 side on 22nd August 2000 in addition to his role at Carrow Road. The Canaries welcomed the move stating that it will strengthen their scouting network as Nigel would spot young talent from Ireland and Europe.

On 6th December 2000, Nigel was appointed Norwich's acting manager following Bryan Hamilton's resignation. A relatively fine set of results under Worthington's stewardship over Christmas and New Year 2000 resulted in him being offered the post permanently (although Norwich were said to have approached David Jones (now of Wolves) first). Worthington accepted on January 1st 2001.

Following the departure of Peter Shreeves as Sheffield Wednesday manager in October 2001, Nigel admitted he would be interested in discussing the position at Hillsborough, especially as he was a former Owl and his family were still in Sheffield. Norwich City were not too concerned with Wednesday languishing at the bottom of Division One and the Canaries flying high. However Nigel seems to be using this possibility of a move to spark discussion for a new improved contract. A contract lasting until June 2005 was received and then extended in December 2002 until June 2006.

Following Terry Venables departure from Leeds as manager in March 2003, Worthington denied any interest in the Leeds role stating that he was "very happy at Norwich". Instead Leeds appointed former Sunderland manager Peter Reid to take the lead at Elland Road until the end of the current season. On April 27th 2003, Nigel was linked with the vacancy at Crystal Palace following Trevor Francis' departure - however Norwich were quick to deny that Worthington was going anywhere.

The Canaries' unbeaten run in September 2003 saw Worthington awarded the Division One Manager of the Month award.

When Sammy McIlroy resigned from the Northern Ireland manager's position in mid-October 2003 to take control at Stockport, Worthington was immediatley linked with the vacancy to manage the poor-performing Irish side that had finished bottom of its Euro 2004 qualifying group. Worthington quickly distanced himself from the vacancy although Ipswich and Northern Ireland midfielder Jim Magilton attempted to muddy the waters and cause discontent at Ipswich's rivals by claiming that Worthington was the right man for the job and that he had expressed an interest in international management !

A second Manager of the Month award came for December 2003 after Norwich had notched up 4 consecutive wins after a draw at Millwall. The sequence was:
Millwall (A) 1-1
Cardiff (H) 4-1
Ipswich (A) 0-2
Forest (H) 1-0
Derby (A) 0-4

On January 11th 2003, the Sunday People speculated that Southampton were looking at Worthington, and Leicester's Micky Adams, as replacements for Gordon Strachan who announced that he was not renewing his contract with the Saints at the end of the season. Worthington has also been linked with the vacancy at Tottenham.

Following Norwich's promotion into the Premiership in April 2004, Nigel received his third Manager of the Month award for Division One.

In September 2004, Worthington was linked with the managerial vacancy at Blackburn whilst his name was linked with replacing Kevin Keegan at Manchester City. In July 2006, he was linked with the vacancy at Wolverhampton Wanderers caused by Glenn Hoddle's resignation.

The 2006/7 season started well despite fan's concerns about he lack of transfer activity with only Lee Croft joining the Canaries. A narrow defeat at Leeds (5th August) was followed by home wins over Preston (8th August) and Luton (12th August). A goalless draw at Derby (19th August) was followed by a convincing 5-1 thrashing of Barnsley (26th August). There was also a 2-0 win at Torquay in the Carling Cup. The departures of Robert Green and Leon McKenzie did little to reassure the fans and this was proven when City lost 3-0 at Coventry (9th September). City threw away a three goal lead to share the points at Soutned on 12th September before a woeful performance at Carrow Road on 16th September saw Crystal Palace steel the points with a late goal from former Ipswich striker Kuqi. A 3-1 defeat at Plymouth saw the club's majority shareholders Delia Smith and Michael Wynn Jones issue an ultimatum that performances must improve. A televised clash at Carrow Road on 1st October 2006 against Burnley proved to be Nigel's downfall as the Canaries crashed to a 4-1 defeat. The following day, Delia and Michael announced Worthington's departure. Many have been linked with the vacancy. Worthingot received a pay-off of £600,000 per the terms of his contract.

By 20th October, Nigel had been linked with the Leeds vacancy and that at Sheffield Wednesday caused by the dismissal of Kevin Blackwell and Paul Sturrock respectively. In December 2006, he was linked with the vacancy at Barnsley. He has also been linked with the vacancy at Hull City caused by Phil Parkinson's departure. In February 2007, he was linked with the vacancy at Swansea City caused by Kenny Jackett's departure. The following month, he was linked with the vacancy at Luton following Mike Newell's sacking but quikcly rejected it saying that he was staying out of football until the summer. "I don't know anything about that so I don't know where it's come from. I'm just enjoying life, spending time with my family doing things you aren't able to do when you are in football and it's lovely. It's the first time in 26 years I've been able to do that.”

Livermore and Worthington returned to management on 11th April 2007 at Leicester City. Worthington replaces Rob Kelly, whose 14-month tenure of the Foxes was brought to an end following a 3-0 Easter Monday defeat at Plymouth Argyle. Their initial appointment ran until the end of the 2006/7 season and they helped the Foxes avoid relegation. However Leicester chairman Milan Mandaric appointed Milton Keynes Dons' manager Martin Allen as the new substantial manager.

Folllowing Lawrie Sanchez's retirement as Northern Ireland coach in May 2007 to accept the manager's role at Fulham, Worthington was named second favourite to take on the national team's coach's position after Aberdeen's Jimmy Nicholls. Worthington was appointed to the post on 1st June 2007.His contract will run until the end of the Euro2008 qualifiers in November 2007. He will be assisted by Southampton first-team coach Glynn Snodin and Bolton Wanderers goalkeeping coach Fred Barber. Worthington's first game in charge will be against Liechtenstein at Windsor Park in August.

"When your country comes knocking there can only be one answer," said Worthington. "There is a good deal of talent in the squad with several younger players of quality emerging and I would like to congratulate Lawrie Sanchez and his support staff for leaving the squad in such good shape. I am fully aware of the enormity of the task and the expectations of the supporters. I have selected my assistant coaches, from the quality of their respective experiences and in the full knowledge that we will be focused on delivering a positive outcome."

Worthington began his international career with a 3-1 win over Liechenstein on 22nd August 2007 with two goals coming from David Healy.

In December 2009, Worthington was linked with the managerial vacancy at Sheffield Wednesday. In May 2010, he was linked with the vacancy at Burnley.

Worthington stepped down as international manager of Northern Ireland on 10th October 2011, staying on just to manage the following day's Euro 2012 clash with Italy. He resigned following a poor qualifying campaign which had attracted a large amount of criticism from supporters, the media and other Irish bosses. Northern Ireland had won just two of their last 23 games under Worthington. His team scored only 12 goals in those 23 fixtures. Likely successors include Iain Dowie, Lawrie Sanchez, Jim Magilton and Michael O'Neill.

On 4th March 2013, Worthington was appointed manager of York City who had sacked Gary Mills after a 2-0 home defeat to Bradford. Worthington's first game in charge saw York lose 3-2 to AFC Wimbledon. He guided the club away from relegation danger in their first season back in the Football League. They finished seventh in the table in 2013/14 after ending the campaign on a 17-match unbeaten run, but were knocked out of the play-offs by eventual winners Fleetwood. However 2014/15 did not start as well and Worthington resigned on 13th October 2014 with the club one place above the relegation zone, having won just once in the league. Worthington said "In recent weeks, performances have not been up to my high standards and I take full responsibility for this.".