By the time The Band did The Last Waltz, the chemistry had changed, and it wasn't a thrill anymore to live that studio kind of life.

Another early influence on Helm was the work of harmonica guitarist and singer Sonny Boy Williamson II who played blues and early rhythm and blues on the King Biscuit Time radio show on KFFA in Helena and performed regularly in Marvell with blues guitarist Robert Lockwood Jr. Although the tumor was then successfully removed Helm's vocal cords were damaged and his clear powerful tenor voice was replaced by a quiet rasp. Helm was known for his deeply soulful country-accented voice multi-instrumental ability and creative drumming style highlighted on many of the Band's recordings such as "The Weight" "Up on Cripple Creek" and "The Night They Drove Old Dixie Down".

 91 in the list of The 100 Greatest Singers of All Time. On April 17 2012 his wife and daughter announced on Helm's website that he was "in the final stages of his battle with cancer" and thanked fans while requesting prayers. His 2007 comeback album Dirt Farmer earned the Grammy Award for Best Traditional Folk Album in February 2008 and in November of that year Rolling Stone magazine ranked him No.