On March 3, 1877, the Red Room was the scene for the historic swearing-in of president-elect Rutherford B. Hayes. Political tensions ran high after his bitterly contested election over Samuel J. Tilden, so Hayes secretly took the Oath of Office at the White House. Inauguration Day fell on a Sunday that year, and this swearing-in avoided a 24-hour delay in the transfer of power and any perceived danger of a coup. President Ulysses Grant slipped away from a dinner party in the next room to attend the ceremony. Hayes took the Oath of Office again in public on March 5 on the East Front of the Capitol without incident.

In 1882, President Chester Arthur commissioned Louis Comfort Tiffany to redecorate the Red Room. The walls were painted Pompeiian red with a richly decorated tawny red frieze of abstract stars. Tiffany embellished the room with a cornice and ceiling medallion stenciled in gold leaf and the ceiling's star pattern was finished in gold and copper tones. The designer also added a new cherry mantel, stained a deep amaranthine red inlaid with brown, amber, and brown-amber red glass tiles that changed in tone with the light.

Throughout the nineteenth century, the room was often used as a music chamber and contained instruments, such as a pianoforte and guitar ordered by First Lady Dolley Madison. Sunday evenings were popular for family gatherings in the Red Room, and President Abraham Lincoln and First Lady Mary Todd Lincoln frequently used the space for informal entertaining.

With Theodore Roosevelt's major State Room renovations of 1902, architect Charles McKim retained the room's red silk velvet walls and strongly contrasted them with the new snowy white neoclassical woodwork. He also moved a striking white marble mantle from the State Dining Room, purchased during the Monroe administration, into the Red Room. Edith Roosevelt displayed her doll collection in the Red Room and, at her suggestion, the portraits of first ladies that traditionally hung in this area were moved to the Ground Floor Corridor.

President Harry Truman's interior renovations, directed by project architect Lorenzo Winslow between 1948-1952, retained the neoclassical design of McKim, Mead and White. He reinstalled Monroe's white marble mantle in the rebuilt Red Room and added a replica of Hoban's cornice.

The present appearance of the Red Room was inspired by the 1971 redecoration that preserved the American Empire style selected in 1962 during the John F. Kennedy administration. The elegance of the Red Room furniture derives from a combination of richly carved and finished woods with decorative hardware made of gilded bronze in characteristic designs such as dolphins, acanthus leaves, lion's heads, and sphinxes. All the fabrics now in the Red Room were woven in the United States from French Empire designs. The walls are covered by a red twill satin fabric with a gold scroll design in the border. The furniture, like the American Empire sofa, is upholstered in a silk of the same shade of red. The carpet of beige, red and gold is a reproduction of an early nineteenth century French Savonnerie carpet in the White House Collection. The thirty-six light French Empire chandelier was fashioned from carved and gilded wood around 1805.

Notable portraits which have been displayed in the Red Room include an 1842 portrait of Angelica Singleton Van Buren by Henry Inman, and Gilbert Stuart's 1804 portrait of First Lady Dolley Madison.