After returning to the United States, he settled into a private practice in New York, and became one of America's leading clinical neurologists. Also he was an instructor at the New York Polyclinic Hospital, and a consultant at the Mount Sinai Hospital and Manhattan State Hospital. Sachs was also the publisher of Journal of Nervous and Mental Disease (1886-1911) and president of the American Neurological Association (1894 and 1932).
The condition known as Tay-Sachs disease is named after Sachs along with English ophthalmologist Warren Tay. Tay first described the red spot on the retina of the eye in 1881, while Sachs described the cellular changes of the disease.
Sachs also published several books, including "Nervous and Mental Disorders From Birth Through Adolescence" and in 1926 the "Normal Child". In this book he advocates a common sense approach to parenting and the rejection of psychological theories, especially Freudian psychology.
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