At the 2001 Goodwill Games in Brisbane, Australia, she was ranked second in the all-around before the final rotation. She was suffering from a stomach illness, however, and she missed three landings on the floor exercise and finished seventh overall. Nevertheless, her balance beam routine was particularly spectacular, featuring what would become her signature double Arabian dismount (later to be named "the Patterson").
Patterson was named the U.S. Junior National All-Around champion in 2002. She had previously received fourth place in 2000 and third place in 2001. By this time, she was largely considered the future of American gymnasts and a viable candidate for the 2004 Olympic All-Around title. From 2002 onward, she would continue to win nearly every All-Around event she entered. She was forced to sit out the 2003 U.S. National Championships because of a broken elbow (a big disappointment for Patterson, as this was to be her first senior nationals). At the 2003 World Gymnastics Championships in Anaheim, California, she earned the all-around silver medal —the first time an American woman had won an all-around medal at that competition since 1994. She also helped her team to earn the team gold medal. It appeared Patterson would once again fight it out with Russia's Svetlana Khorkina in Athens.
Patterson won the all around at the prestigious American Cup competition in both 2003 and 2004. (This event helped to launch Nadia Comaneci's career before the Olympics in 1976.) In 2003, Patterson was the youngest competitor, having just turned 15, and it was her first major senior competition. In 2004, she swept the meet, winning all four events and the all around, collecting a total of $14,000 for her wins ($10,000 for the all around, $1,000 per event).
In 2004, she became a co-champion with Courtney Kupets in the all-around event at the U.S. Gymnastics Championships. She also won the floor exercise and placed second on balance beam.
At the 2004 Olympic trials, Patterson had two uncharacteristic falls on balance beam over the course of two days, dropping her to third place. Although she did not earn an automatic Olympic berth at this competition, her successful performances at the training camp following trials were more than enough to place her on the team. Few doubted that she was a huge contender for the Olympic All-Around title.
In the Individual All-Around, Carly was back to her best and the competition proved to be the much-anticipated battle between Carly and legend Svetlana Khorkina. After scoring lower than usual on the vault (9.375), Carly was stronger on her last three events, scoring 9.575 on uneven bars, 9.725 on the balance beam, and 9.712 on the floor exercise. She won the gold medal, an achievement that had only been attained by one other American gymnast, Mary Lou Retton, exactly twenty years before during the 1984 summer games. Carly became the first American woman to ever win the Olympic All-Around title in a fully attended Olympic Games.
On August 23, 2004 she competed in the finals for the beam event where she received a score of 9.775 and won the silver medal behind Catalina Ponor of Romania.
Leading up to the 2004 Olympic Games, she was prepared by her two former Soviet coaches: the famous Russian acrobat Evgeny Marchenko, who immigrated to the United States from Latvia after the Collapse of the Soviet Union, and Natalya Boyarskaya.
Carly Patterson has done the talk show circuit and has made numerous guest appearances since the Athens Games. Although some hoped that she would return to full training to defend her all-around gold, Patterson decided in 2006 she would not plan to participate in the 2008 Olympic Games and would retire from Gymnastics. Her coach said in a TV interview, "It's hard to top an All-Around Gold."
She has stayed occupied with event appearances, gymnastics-related and otherwise. She has also landed a number of high profile corporate sponsorships; she appeared in a Mobile ESPN commercial aired during Super Bowl XL. She also has finished her authorized biography, which was released in April 2006.
On September 8, 2006, during the "results" show, she joined Cheech Marin and Lea Thompson in the bottom three. The audience, however, spared Patterson from elimination to continue competing the next week on Thursday, September 14.
On September 15, 2006, during the "results" show, Carly Patterson was eliminated from the competition (singing a duet with Jesse McCartney). Patterson said that she would continue to sing. She also encouraged the audience to continue voting for the remaining celebrities because the cause is charity.
On February 4, 2008, Carly signed a recording contract with MusicMind Records, a Chicago based Indie label. Her new single Temporary Life (Ordinary Girl) was released on March 25, 2008. Her debut album (title unknown) was scheduled for release August 5, 2008, coincidentally, the same week as the start of the 2008 Olympic Games in Beijing. The CD did not release on the day it was supposed to. Carly is still working on it and it may come out soon.
On September 10, 2008, a remixed version of Carly's Temporary Life single was played on the Bobby Bones Show. The mixed version featured the new artist, Captain Caucasian (Bobby Bones's rapper pseudonym).