After establishing herself on stage in Canada and New York City, Ivey made her film debut in 1985, appearing in both The Explorers (as River Phoenix's mother) and The Color Purple (with Whoopi Goldberg and Oprah Winfrey). Often cast as slightly daft matrons, one of her larger film roles was as Margaret Alford in The Addams Family and Addams Family Values. Other films include Dirty Rotten Scoundrels (directed by Frank Oz), the 1995 Sabrina (with Julia Ormond), 1993's The Adventures of Huck Finn (as Widow Douglas), Sleepless in Seattle, The Help (with Octavia Spencer), The Scarlet Letter, Simon Birch, Rush Hour 3 (as a nun), Postcards from the Edge, and Ghost Town (with Ricky Gervais).
On Broadway, Ivey originated the roles of Yvonne and Naomi Eisen in the musical Sunday in the Park with George while mostly appearing in stage classics: Shakespeare, Noel Coward's Present Laughter, The Rivals as Mrs. Malaprop, and The Importance of Being Earnest as Miss Prism. She originated the title role in the off-Broadway production of Driving Miss Daisy. TV includes a regular role on the one-season sitcom Easy Street (as Loni Anderson's snobbish sister-in-law), recurring on Boardwalk Empire (temperance leader Mrs. McGarry), and guest parts on Law & Order, Frasier, Sex and the City, Oz, and Monk.