She was appointed the 12th chancellor of North Carolina State University in Raleigh, North Carolina in August 1998, succeeding Dr. Larry K. Monteith. She is the university's first female chief executive.
Prior to her appointment as chancellor of NCSU, Fox served as Vice President for Research at the University of Texas at Austin. Fox is a member of the National Academy of Sciences and has served as served as president of the scientific research society Sigma Xi.
Fox is well-connected within the U.S. Republican Party, having served as a science advisor to George W. Bush during his tenure as governor of Texas. She was on the short list of candidates to head the White House Office of Science and Technology Policy in the Bush presidential administration.