Leitch was a stunt double for Brad Pitt five times and two times for Jean-Claude Van Damme.[citation needed] Leitch and his crew won two awards for The Bourne Ultimatum at the Screen Actors Guild Awards. He also shared a 2008 Taurus World Stunt Award with fellow stunt-person Kai Martin for high work.

He wrote and starred in Confessions of an Action Star, a parody of action films and the action film industry released in 2009.

Leitch and Chad Stahelski opened an action design production company called 87Eleven in 1997. In 2009, Stahelski and Leitch were second-unit directors and stunt co-ordinators on Ninja Assassin. The two co-directed the 2014 film John Wick, although Leitch himself was not credited as co-director. Leitch executive produced the three John Wick sequels, which Stahelski solo directed.

He moved on to direct films such as Atomic Blonde, Deadpool 2 and Fast & Furious Presents: Hobbs & Shaw with his wife and creative partner Kelly McCormick serving as a producer. In 2022, he also directed Brad Pitt in the action-thriller Bullet Train.

In September 2020, Leitch signed on to direct and produce stuntman drama The Fall Guy for Universal Pictures, with Drew Pearce writing the screenplay and Ryan Gosling and Emily Blunt starring; the film, based on the 1980s television series of the same name, released in the United States on May 3, 2024.