Horowitz later played in Berlin, Paris and London, and made his United States debut at Carnegie Hall in New York City with Tchaikovsky's Piano Concerto No. 1 in 1928. He soon began making recordings of his music for studios in Europe and the United States, all of which have since been released on CD.
Despite his marriage to conductor Arturo Toscanini’s daughter, Wanda, in 1933, Horowitz was plagued by rumours of homosexuality and he sought psychiatric treatment through much of his adult life. In his last years, Horowitz was awarded the Presidential Medal of Freedom by President Ronald Reagan and embarked on his final tour of Europe in 1987. He died two years later of a heart attack in New York, aged 86.