Vicious joined the Sex Pistols in early 1977 to replace Glen Matlock, who had fallen out of favour with the rest of the group. Due to intravenous drug use, Vicious was hospitalized with hepatitis during the recording of the Sex Pistols' debut album Never Mind the Bollocks.
During the brief and chaotic ascendancy of the Sex Pistols, Vicious met eventual girlfriend and manager Nancy Spungen. Spungen and Vicious entered a destructive codependent relationship based on drug use. This culminated in Spungen's death from an apparent stab wound, with Vicious under suspicion of having committed Spungen's murder, Vicious was released on bail
Vicious was arrested again for assaulting Todd Smith, brother of Patti Smith, at a night club and underwent drug rehabilitation on Riker's Island.
In celebration of Vicious' release from prison, a party was held by his mother at his girlfriend's residence in Greenwich Village, Vicious' mother had been supplying Vicious with drugs and paraphernalia from a young age and assisted him in procuring heroin late that night. Vicious died in his sleep, having overdosed on the heroin his mother had procured. After Vicious' death, a compilation of live material recorded during his brief solo career was packaged and released as Sid Sings.