West turned professional in July 1980, and made his debut for Sunderland on 20 April 1981 against West Bromwich Albion in a 2–1 defeat at The Hawthorns under caretaker-manager Mick Docherty. The club narrowly avoided relegation out of the First Division in 1981–82 under new boss Alan Durban, finishing just one place and two points above relegated Leeds United. They then finished four places and three points above the drop in 1982–83. West was the club's top scorer in 1983–84 with nine goals. The next season, he scored three goals over the two legs in the League Cup semi-final win over Chelsea, but was left out of the Wembley final by manager Len Ashurst. Following this snub he joined league rivals Watford for £115,000 in March 1985. The "Black Cats" went on to lose their top-flight status in 1984–85, finishing two places and ten points short of safety. He scored 28 goals in 122 competitive appearances for Sunderland.