His coaching career started in 2000 at Carlton Football Club as an assistant to David Parkin and then to Wayne Brittain in 2001, before applying for the senior coaching roles at both West Coast and Fremantle at the end of the 2001 season. Eventually, he was appointed to the senior coaching role at West Coast, the club he had formerly played for, where he achieved some level of immediate success, taking the club back to the finals in his first season. After a string of early finals exits in 2002, 2003 and 2004, Worsfold finally took the club back to the Grand Final in 2005, where the Eagles were narrowly defeated by four points by the Sydney Swans.