Unlike many of her contemporaries, Roth excelled at designing modern-day costumes, and has also shown a flair for period pieces. She earned her degree from Carnegie Tech (now Carnegie-Mellon University) and by the late 1950s was working in New York theater. Among her numerous stage credits are "Purlie Victorious" (1961) and its musical version "Purlie" (1970), "Seesaw" (1973), her Tony-nominated work for the all-star revival of "The Royal Family" (1975), "The Crucifer of Blood" (1978) and "The House of Blue Leaves" (1986) and more recently, "Present Laughter" (1996).

On screen, Roth has designed signature costumes for characters as diverse as Jon Voight's titular "Midnight Cowboy" (1969, the white fringed jacket), Jane Fonda's prostitute in "Klute" (1971), Meryl Streep's "Silkwood" (1983), Glenn Close's "Maxie" (1985) and Melanie Griffith's "Working Girl" (1988). Roth has frequently dressed these stars in many of their other vehicles, always providing appropriate costumes, whether it be middle-class (Glenn Close in "The World According to Garp", 1982) or high society (Melanie Griffith in "Bonfire of the Vanities" 1990). Her work with Jane Fonda took her from her stylish "Klute" wear to the frumpy out-of-touch uniform favored by her meek "9 to 5" character, to the disheveled look donned by the alcohol-hazed woman in "The Morning After" (1986), each one ringing true in the film's context. "Dave" (1992), and "Primary Colors" (1998) proved Roth could outfit the White House, while "A Stranger Among Us" showed her capabilities with the strictly traditional, finely crafted clothing favored by Hasidim. A frequent collaborator of Mike Nichols, Roth has costumed no fewer than ten of his films, from the hard-hitting biopic "Silkwood" to the zany comedy "What Planet Are You From?" (2000).

The costumer has also demonstrated her range in several period dramas, such as her BAFTA Award-winning work in "The Day of the Locust" (1975), the Patsy Cline biopic "Sweet Dreams" (1985) and her Oscar-nominated efforts in Robert Benton's "Places in the Heart" (1984). The costumes for Anthony Minghella's "The English Patient" won Roth her first Oscar after over 30 prolific years in the movie business, and upon reteaming with Minghella in "The Talented Mr. Ripley", she was nominated for the prestigious trophy again, this time for her 1940s jet-set wardrobe.

On the small screen, Roth worked on the TV-movies "The Rivalry" and "The Silence" (both NBC, 1975) and the Bette Davis-Gena Rowlands vehicle "Strangers: The Story of a Mother and Daughter" (CBS, 1979). She served as a consultant on the 1986 PBS' miniseries "Roanoak", for which she garnered an Emmy nod. That network also aired productions of "The House of Blue Leaves" (1987) and "O Pioneers!" (1991), for which Roth recreated her original stage designs.