Wilkerson served as a pastor in small churches in Scottdale and Philipsburg, Pennsylvania, until he saw a photograph in Life Magazine in 1958 of seven New York City teenagers charged with murder. He later wrote, that as he felt the Holy Spirit move him with compassion, he was drawn to go to New York in February 1958. It was then that he began his street ministry to underprivileged inner-city youth.

Wilkerson is well-known for these early years of his ministry to young drug addicts and gang members in New York City in the 1950s and 1960s. He co-authored a book with John and Elizabeth Sherrill about his work with the New York drug addicts, The Cross and the Switchblade, which became a best-seller. Included in the book is the story of Nicky Cruz's decision to become a Christian, who later wrote "Run Baby Run" about his own life. The The Cross and the Switchblade has sold over 50 million copies in over thirty languages since it was published in 1963. In 1970 the book was also released under the same title as aHollywood movie starring Pat Boone as Wilkerson and Erik Estrada as Cruz. The book was included among the 100 most important Christian books of the 20th century.[citation needed]

In the early 1960s, Wilkerson, his wife Gwen, Loren and Darlene Cunningham, and Howard and Pat Foltz, prayed together in Colorado. From this developed three ministries: Teen Challenge USA (Wilkerson's), Youth With A Mission (Cunningham's), and Teen Challenge Europe-Asia (Foltz's), which have reached youth and adults worldwide, many with life-controlling problems, through its centers and ministry. Teen Challenge's USA and Europe-Asia ministry is a biblically-based recovery program for drug addicts that has been recognized as one of the most effective efforts of its kind.[1]

In 1967, Wilkerson began Youth Crusades, an evangelistic ministry that was aimed to reach teenagers whom Wilkerson called "goodniks" — middle-class youth who were restless and bored. His goal was to prevent them from becoming heavily involved with drugs, alcohol, or violence. Through this ministry, CURE Corps (Collegiate Urban Renewal Effort) was founded. It was intended to be something of a Christian version of the Peace Corps and Volunteers in Service to America (VISTA).

In 1971, Wilkerson moved his ministry headquarters to the town of Lindale, Texas (just outside of Tyler), where he founded World Challenge. The organization's mission is to promote and spread the Gospel throughout the world.

In 1986, while walking down 42nd Street in New York City at midnight, Wilkerson believes that the Holy Spirit called him to return to New York City and to raise up a ministry in Times Square. This resulted in the establishment of Times Square Church which opened its doors in October 1987. The church first occupied rented auditoriums in Times Square (Town Hall and the Nederlander Theater), later moving to the historic Mark Hellinger Theatre, which the ministry purchased in 1989 and in which it has operated ever since.

For over four decades, Wilkerson's ministry has included preaching, teaching and writing. He has authored over 30 books.

Since the 1990s, Wilkerson has focused his efforts to encourage pastors and their families throughout the world to "renew their passion for Christ". In his own words:

"I've been an evangelist for 50 years, but I didn't want to preach to pastors until I had gray hair, until I'd pastored. Now after 15 years of pastoring, sharing the hurts, pains, and difficulties of the ministry as a pastor, I felt the Lord finally release me, that I might have something to say."[citation needed]

Wilkerson and his wife Gwen moved to New York City at the inception of Times Square Church in 1987, and in 2006 began splitting their time between New York and Texas (near their World Challenge offices in Lindale). They have four children and eleven grandchildren. His son Gary Wilkerson has also begun to gain recognition as aChristian minister and evangelist.

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