Howe was born in Indiana and raised in Saratoga, New York, Howe was a freelancer for the New York Herald for a time, before becoming a political operative in the early 20th Century. He met Franklin Roosevelt in 1909, serving more or less as Roosevelt's aide for the remainder of Howe's life. After Roosevelt contracted polio in 1921, resulting in partial paralysis, Howe became Roosevelt's public representative, keeping his political career alive during his recovery. He arranged Roosevelt's 1924 "Happy Warrior" Democratic Convention speech endorsing Al Smith, that returned FDR to the public eye, and helped to run Roosevelt's narrowly successful 1928 campaign to become Governor of New York. Howe then spent the next four years laying the groundwork for Roosevelt's landslide 1932 presidential victory. Named Roosevelt's secretary, Howe helped the president to shape the early programs of the New Deal, particularly the Civilian Conservation Corps. Howe grew ill shortly after Roosevelt's election, and died before the end of his first term.
Lou Howe did not attend the 1932 Democratic Convention in Chicago. Joe Steele's camp appealed to the populists by claiming that Howe refused come to a "hick town" like Chicago. Naturally, the Roosevelt camp countered by reminding everyone that Howe was an invalid and didn't travel at all.