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On 1 July 2019, Smith was signed by Millwall. Smith scored a 13 minute hat-trick in a win over Nottingham Forest on 6 March 2020.

On 31 January 2017, the final day of the January transfer window, QPR signed Smith for an undisclosed fee believed to be £500,000, possibly rising to an eventual £1m based on incentives. Smith signed a three-and-a-half year contract. He contributed 20 league goals in his first full season at the club, with 11 goals and 9 assists in the Championship, making him also the club's top goal scorer in the 2017–18 season.

He did not find the net again for another four matches, until Leeds' New Year Day home Championship fixture with Blackburn Rovers on 1 January 2014, a consolation goal on 53 minutes.

On 11 January 2014, Smith was brought on as a substitute at half time in the away Championship local derby against Sheffield Wednesday, which Leeds United were losing 2–0. However, in an aerial challenge just minutes after the restart, Smith was adjudged to have gone in dangerously high on defender Réda Johnson and was awarded a straight red card by referee Lee Probert. Leeds manager Brian McDermott said that the club would be appealing the red card. Leeds eventually lost the match 6–0, which was Wednesday's biggest local derby victory. The Football Association upheld Probert's decision and confirmed a three match ban for the player. McDermott admitted how upset and disappointed he was at the FA's decision.

On 10 July 2014, it was announced that Leeds had rejected an undisclosed bid from Championship rivals Millwall for Smith. On 11 July, he scored six goals in a 16–0 victory in Leeds' first pre season game against Italian side FC Gherdeina. On 1 August, Smith was assigned the Leeds number 9 shirt for the 2014–15 season. On 18 August, Smith signed a new three-year deal with the club. On 27 August, Smith scored his first goal of the season against Bradford City in the League Cup, opening the scoring in a 2–1 defeat.

On 1 September 2014, the final day of the transfer window, Fulham signed Smith for an undisclosed fee believed to be £800,000. Smith signed a three-year contract with an option of extending it by a further year. Smith was given a straight red card 18 minutes into his Fulham debut in a 3–0 loss against Reading. Following the sacking of Felix Magath and the subsequent appointment of Kit Symons as manager soon after, Smith was limited to a further two substitute appearances in almost three months at Craven Cottage.

On 27 January 2013, in Smith's second season at the club, he scored two goals to ensure a 3–2 win over Liverpool in the 4th round of the FA Cup. In the 5th-round game played on 16 February 2013, Smith scored against Liverpool's rivals, Everton in the 95th minute, to achieve a 2-2 draw. Oldham's FA Cup campaign continued with a 5th round replay at Goodison Park on 26 February, in which, Oldham were defeated 3–1 with Smith again scoring for Oldham, meaning he finished Oldham's FA Cup campaign with 4 goals from 4 appearances and all goals coming against Premier League opposition. For his performance in the 5th round, Smith was voted as the Player of the 5th Round.

Smith scored three goals in his last three appearances of the season. The first came against Bury at Gigg Lane, a back post header ten minutes from time which sparked jubilant scenes in the sold out away end and relegated Bury after the game ended 1–0. The others came against Yeovil Town and Crawley Town, all of which culminated in wins and ultimately ensured Oldham's survival in League One. Smith won League 1 Player of the Month for April 2013 having scored three vital goals for Latics in five appearances, securing Oldham's survival in the league.

Smith finished the 2012–13 season with 11 goals in all competitions. On 23 May 2013, with reported interest from a host of Championship clubs, Smith rejected an improved contract offer from Oldham Athletic.

On 10 June 2013, Smith agreed a two-year deal with Championship club Leeds United after turning down a new contract with Oldham Athletic. Smith was handed the Number 20 shirt at Leeds for the 2013–14 season. He scored 2 goals, both headers, in his first match for Leeds, a 5–0 friendly win against Farsley A.F.C.

Smith made his Leeds United debut as a substitute in the first game of the season against Brighton & Hove Albion on 3 August, in which he gained an assist for Luke Murphy's 94th-minute winner as Leeds earned a 2–1 victory.

Smith scored his first goal for Leeds on 27 August 2013 in Leeds' 3–1 League Cup victory against Doncaster Rovers who were managed by Paul Dickov who signed Smith for previous club Oldham Athletic. He scored his first league goal for Leeds in a 2–1 defeat at home to Burnley on 21 September 2013. His second and third league goals for Leeds came against Birmingham City on 20 October 2013 where Leeds won 4–0.

He followed this up six days later with a second-minute goal in Leeds' 3–2 away defeat in the Championship at Yorkshire rivals Huddersfield Town. Smith didn't find the back of the net again until the home Championship match with Watford on 7 December 2013, which ended in a 3–3 draw. Smith scored in the 56th minute, in between Danny Pugh and Ross McCormack goals.

Seven days later, Smith opened the scoring in Leeds' 3–0 away Championship win at Doncaster Rovers on 14 December 2013.

Smith finished the 2013–14 season with 13 goals and 8 assists in all competitions. On 3 May, at the club's annual awards ceremony, Smith won the Community Player Of The Year Award and the Fastest Goal Of The Season Award for his goal against Huddersfield Town.

In turn, Smith went on loan to League One side Bristol City on 25 November for two months. This was then later extended by a further month until 1 March. After joining Bristol City on loan, Smith registered his first goal for the club in his 5th appearance, scoring the opener in a 2–1 home victory against West Country rivals Yeovil Town on Boxing Day. He then went on to score an unprecedented nine goals in five games – including four in one match, away at Gillingham in the Football League Trophy Southern Area Final. After completing his hat-trick with an audacious back-heel, Smith's fourth was a sublime volley from distance, for which he was later awarded "Goal of the Tournament". He was the first player to score four goals in a game for Bristol City since Paul Agostino against St Albans in 1996. Another goal from Smith in the second leg of the tie helped secure Bristol City a place in the Football League Trophy final at Wembley against Walsall on March 22, however due his loan agreement ending on March 1, he would be ineligible to play in this fixture. Despite this, manager Steve Cotterill insisted Smith join the squad on their trip to Wembley as a guest, to which Smith said he felt "honoured" and added it being "a touch of class from the manager." Soon after, Smith took his tally to 13 goals in 17 appearances for the Robins, when he opened the scoring against Sheffield United. On the conclusion of his loan spell, Cotterill hailed Smith's impact and contribution at the club over the course of the three months as "huge".

Smith returned to Fulham on 1 March and scored his first goal for the club five days later in his Craven Cottage debut against Bournemouth. In the following game, Smith scored the equalizer against Sheffield Wednesday away at Hillsborough in a 1–1 draw. He then went on to score goals against Wigan, Blackpool and Norwich, which ultimately secured Fulham's Championship status. Smith finished the 2014–15 season with 19 goals in all competitions.

Smith has been referred to as a "classic centre forward" or "traditional number 9" owing to his size, strength, powerful shot and excellent heading ability. Former Oldham manager Lee Johnson as well as former Oldham caretaker manager and Bolton player Tony Philliskirk have likened Smith to both Duncan Ferguson and Andy Carroll. Following Oldham's 3–2 win at home to Liverpool in January 2013, Liverpool manager Brendan Rodgers compared Smith to Didier Drogba.

Smith made his competitive debut on the first day of the 2011–12 season, starting the Football League match against Sheffield United. He scored his first Oldham goal on 16 August, which won the game against Scunthorpe. Smith scored his second goal for the club with his first touch after coming on as a substitute against Leyton Orient in a 3–1 victory for the Latics. Smith then gained a re-call to Oldham's starting eleven in a league game against Chesterfield on 2 January 2012, scoring a headed goal in the opening half of a game that ended in a 1–1 draw. On 15 March 2012, after only 4 starts in 33 appearances for the Latics, manager Paul Dickov allowed Smith to go on loan to League Two side Macclesfield Town for the remaining 6 weeks of the season.

Smith joined Oldham Athletic in May 2011 after the completion of his university studies, signing a two-year contract.

In April 2011, after a prolific season in the Conference North, Smith was called up for the England C team.

Upon his return to England, ahead of the 2010–11 season and his final year of University, Smith signed for Redditch United in the Conference North. He initially went on a short-term loan with Littleton, scoring an impressive nine goals in three games. Upon returning to Redditch United, Smith scored five goals in five starts and subsequently moved to Droylsden in September 2010, largely due to the clubs close proximity to Manchester University, where he was returning for his final year of studies. Smith rejoined Redditch in December, before making a final move to Solihull Moors in February 2011, where he scored twelve goals in fourteen appearances. He finished the season having scored 32 goals, 23 of which were in the Conference North, making him one of the league's leading scorers in the 2010–11 season.

Smith spent a year as a trainee at Cheltenham Town, before being released at the age of 18. He then gained non-league football experience with New Mills, whilst studying at the University of Manchester. He made his debut for New Mills in the North West Counties Premier League as a substitute against Silsden in October 2008, scoring in a 2–0 win. He went on to play a crucial role in the club's amazing 21 game winning run, scoring 13 goals over the season including a hat trick against Alsager Town in April 2009. As he was due to spend a year studying in America, he left the Millers that summer.

He completed his A-Levels in Cheltenham's Pate's Grammar School whilst a trainee at Cheltenham Town. In September 2007 he went to Manchester to study for a degree at Manchester Business School, University of Manchester, with a year spent in the United States at Arizona State University. He graduated in the summer of 2011 with a First class degree in International Management with American Business Studies. Whilst at Manchester he was also captain of the University's men's football team, was called up to the Great Britain squad for the World University Games in China in 2011 and was named the University's Sportsman of the Year.

Mathieu James Patrick Smith (born 7 June 1989) is an English professional footballer who plays as a striker for Championship club Millwall.