The 77-year-old music legend was struck down with a dizzy spell during the opening night of his latest tour in St Paul, Minnesota and taken to hospital.
But Richie was in good spirits as he performed at the PPG Paints Arena on Tuesday, admitting he had ignored the advice of friends to carry on resting after the medical incident.
Speaking to the crowd, Richie said: "I had you worried there for a minute, huh?
"You have no idea what I have been through in the last 24 hours, listening to my friends tell me their advice on what I should be doing."
Richie was at his best as he gave his fans his greatest hits and his on-stage jokes continued throughout the night.
Performing tracks like Hello and Running with the Night and his former group the Commodores' hits Easy and Three Times a Lady.
After performing 1977 Commodores classic Brick House, Richie joking told his fans: "I have the best seat in the house. I see everything. And that was absolutely the nastiest dancing I've ever seen in my life. If the grandchildren and the children could see Mom and Dad in this condition..."
Richie suffered his dizzy spell last week during a rendition of his 1986 hit single Dancing on the Ceiling and in Pittsburgh he ensured he showed his concerned fans that he was fighting fit by gyrating across the stage as jets of fog shot into the air.
Other highlights included Stuck on You, Endless Love and a "virtual duet" with a video of Kenny Rogers for the song Lady which Richie had written for the country music artist and his close friend.
Richie also treated fans to his 1985 song We Are the World - which he co-wrote with Michael Jackson to raise money for Ethiopian famine victims - and closing track All Night Long (All Night).
Richie's ex-wife Brenda - who was married to the musician from 1975 until 1993 - had taken to social media platform X to back Richie's return to the stage.
A fan on X wrote: "He is iconic. He does NOT need anyone telling him when to quit."
Brenda reposted the message in support of the statement.
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