His greatest popular success as a writer was his final novel, Elizabeth and After, which won the 1999 Governor General's Award for English-language Fiction only a few weeks before his death. He had been nominated twice previously, but had not won, in 1979 for The Sweet Second Summer of Kitty Malone and in 1997 for Last Seen.
A founding member of the Writers' Union of Canada, he served on the executive board for many years and as president in 1986. During his presidency the Writer's Union was finally able to persuade the government of Canada to form a commission and establish a Public Lending Right program. He also served on the Toronto Arts Council as chair of the Literary Division and was able to obtain increased funding for writers. In recognition of this work he was awarded a Toronto Arts Award and the Harbourfront Prize.
Cohen died after a battle with lung cancer. A Canadian literary award, the Matt Cohen Prize - In Celebration of a Writing Life, is presented in Cohen's memory by the Writer's Trust of Canada.
He also published a number of children's books under the pseudonym Teddy Jam. Cohen's authorship of the Teddy Jam books was not revealed until after his death. The Fishing Summer was also nominated for a Governor General's Award for children's literature in 1997, making Cohen one of the few writers ever to be nominated for Governor General's Awards in two different categories in the same year.
A film adaptation of his 1990 novel Emotional Arithmetic has been produced by Triptych films starring Max von Sydow, Christopher Plummer, Gabriel Byrne and Susan Sarandon. It was the closing Gala at the Toronto International Film Festival in 2007.
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