Returning to the United States in 1954 Patton, now a Captain, was initially assigned to West Point but was quickly picked up as part of an exchange program and was sent to teach at the United States Naval Academy. Patton served a total of three tours of duty in Vietnam, the first from April 1962 to April 1963 at Military Assistance Command, Vietnam-Special Operations, during which he was promoted to Lieutenant Colonel. He then took command of the 2nd Medium Tank Battalion, 81st Armored Regiment of the 1st Armored Division at Ft. Hood Texas, before his second tour in 1967, this one lasting only three months. During Patton's final and most intense tour, lasting from January 1968 to January 1969, he was awarded two Distinguished Service Crosses for his actions on the battlefield. During this final tour he was initially assigned as Chief of Operations and Plans at Headquarters, United States Army Vietnam however after his promotion to Colonel in April 1968 he was given command of the 11th Armored Cavalry.
During his three tours in Vietnam, Patton, who frequently used helicopters as a mobile command post, was shot down no less than three times and was awarded the Distinguished Flying Cross. After Vietnam he was promoted to Brigadier General in June 1970 before becoming the commanding officer of the U.S. 2nd Armored Division, a unit his father had commanded in North Africa during World War II, and making this the only time in U.S. Army history that a father and a son had each commanded the same division. Additionally, the 2nd Armored Division at the time of Patton's command was billeted near the city of Stuttgart. Manfred Rommel, son of Field Marshal Erwin Rommel, was mayor of the city at the time, and the sons of the two former adversaries entered a much publicized friendship. Both men also shared the same birthday, December 24.
His decorations included the Distinguished Service Cross with one oak leaf cluster, the Silver Star with one oak leaf cluster, the Legion of Merit with two oak leaf clusters, the Distinguished Flying Cross, the Meritorious Service Medal, and the Purple Heart as well as Parachutist Badge and Aircrew Badge.
In the years after his 1980 retirement, Patton turned an estate owned by his father located north of Boston into the 250-acre Green Meadows Farm, where he named the fields after Vietnam soldiers who died under his command. In 1997 Patton worked alongside author Brian Sobel wrote The Fighting Pattons a book which served as an official family biography of his father as well as a comparison between the military of his father’s generation and that of his son, a time which covered five conflicts and almost 70 years of combined service.
He died from a form of Parkinson's disease at the age of 80 in 2004 and is survived by his wife, the former Joanne Holbrook, and their five children, Margaret Georgina Patton, George S. Patton V, Robert H. Patton, Helen Patton-Plusczyk, and Benjamin Wilson Patton; six grandchildren; and a great-grandson.
Though given the name Junior, Patton's father was actually the third George Smith Patton. For this reason, Patton was christened George Patton IV. Following his father's death in 1945, Patton changed his legal name to George Smith Patton, dropping the Roman numerals. His eldest son, technically the fifth George Patton, is also known as George Smith Patton, Jr.