Mizell was born in Leakesville, Mississippi, but started playing baseball in Vinegar Bend, Alabama, the town from which he drew his nickname. Signed by the Cardinals in 1949, he debuted with them in 1952, ranking among the Top 10 in the National League (NL) in strikeouts for two years before spending 1954 and 1955 in military service. He returned to the Cardinals in 1956 and was named to two Major League Baseball All-Star Games in 1959, but St. Louis felt like he never attained his full potential. They traded him to Pittsburgh early in the 1960 season, and Mizell led the NL in winning percentage (.636) as the Pirates defeated the New York Yankees in the 1960 World Series. He remained with the Pirates until early in the 1962 season, last pitching in the major leagues with the Mets.