Cox, who is a native of the Grand Strand, is well known throughout the area for her award-winning plein air paintings and large-scale wall murals. She has been a member of the Waccamaw Arts and Crafts Guild and Seacoast Artist Guild of South Carolina and currently participates in WetCanvas.com, an international art website, where she has contributed two instructional articles and several demonstrations. Cox also belongs to the regional Southern Ladies Art Conference, and is the founder of a local plein air painting group, the Plein Air Landscape Society (PALS). She is a signature member of the International Plein Air Painters group. Her work has won awards in Wilmington, NC; Southport, NC; Moncks Corner, SC and Orlando, FL. They include a 2009 first prize for her painting Riverwalk at the 2014 Plein Air Paint-Out in Conway and another first place in 2010 at the Plein Air Paint-Out in Kinston, N.C. for Morning Light. Subject matter for Ruth Cox consists of the area around where she lives: Brookgreen Garden, the Waccamaw River, the local farm country, salt marshes and Atlantic beaches. In fact, she considers the world her studio, saying "I try to capture special effects of light and atmosphere that are exciting or emotionally moving to me. I paint with oils (or acrylics) on canvas as panels, using large brushes and a palette knife to apply colors in connected shapes of light and shadow to set the composition. Then I develop these shapes further to indicate form and meaning, with variety in value, color, texture and edges. I stop short of realistic detail, using just enough to give an impression, allowing the viewer to fill in the rest. The effect is realistic with identifiable objects, without belaboring the detail work." About her murals, the artist says, "I have painted murals in homes, schools and businesses in North and South Carolina, Virginia and Maryland. I have painted backdrops for several local theaters, including Snoopy's Magic On Ice, All American Music Theatre, Gatlin Brothers Theater and Theatre of the Republic. My murals include the Conway Chamber of Commerce, touch-up of the Aynor train mural, many hotel murals in Myrtle Beach and the Black Water Market in downtown Conway." Cox also teaches oil and acrylic painting at Sunset River Marketplace on Wednesday afternoons and Friday mornings.