Rumble Fish was made into a film in 1983 by Francis Ford Coppola, with Matt Dillon as Rusty James and Micky Rourke as the Motorcycle Boy; the film also starred Dennis Hopper, Tom Waits, and Nicolas Cage. Hinton also makes a brief appearance. She and Coppola collaborated to write the screenplay.

The novel was adapted as a record and cassette by Viking in 1977.

Another recording was produced by Recorded Books LLC in 1985.