Spaghetti Westerns have left their mark on popular culture, strongly influencing numerous works produced in and outside of Italy. In later years, there were the "return-of stories" films Django Strikes Again with Franco Nero and Troublemakers with Terence Hill and Bud Spencer. Clint Eastwood's first American Western film, Hang 'Em High, incorporates elements of spaghetti Westerns.

American director Quentin Tarantino has utilized elements of spaghetti Westerns in his films Kill Bill (combined with kung fu movies), Inglourious Basterds (set in Nazi-occupied France), Django Unchained (set in the American South during the time of slavery), The Hateful Eight (set in Wyoming post-US Civil War), and Once Upon a Time in Hollywood (about fictional American actor Rick Dalton sometimes working in spaghetti Westerns).

The Back to the Future trilogy pays homage to spaghetti Westerns (especially Sergio Leone's Dollars Trilogy) on a variety of occasions, most notably in the third film. The American animated film Rango incorporates elements of spaghetti Westerns, including a character (the mystical "Spirit of the West", regarded as a sort of deity among the characters) appearing to the protagonist as an elderly Man with No Name. The 1985 Japanese film Tampopo was promoted as a "ramen Western". Japanese director Takashi Miike paid tribute to the genre with Sukiyaki Western Django, a Western set in Japan that derives influence from both Django and the Dollars Trilogy.

The Bollywood film Sholay was often referred to as a "Curry Western". A more accurate genre label for the film is the "Dacoit Western", as it combined the conventions of Indian dacoit films, such as Mother India and Gunga Jumna, with that of spaghetti Westerns. Sholay spawned its own genre of "Dacoit Western" films in Bollywood during the 1970s.

In the Soviet Union, the spaghetti Western was adapted into the Ostern ("Eastern") genre of Soviet films. The Wild West setting was replaced by an Eastern setting in the steppes of the Caucasus, while Western stock characters, such as "cowboys and Indians", were replaced by Caucasian stock characters, such as bandits and harems. A famous example of the genre was White Sun of the Desert, which was popular in the Soviet Union.

American heavy metal band Metallica has used a Ennio Morricone's composition, "The Ecstasy of Gold", from The Good, the Bad and the Ugly, to open several of their concerts. An Australian band, the Tango Saloon, combined elements of tango music with influences from spaghetti Western scores. The band Ghoultown also derives influence from spaghetti Westerns. The music video for the song "Knights of Cydonia", by the English rock band Muse, is influenced by spaghetti Westerns. The band Big Audio Dynamite used music samples from spaghetti Westerns when mixing their song "Medicine Show". Within the song, there are samples from spaghetti Western movies such as A Fistful of Dollars, The Good, the Bad and the Ugly, and Duck, You Sucker!.

Video game studio Rockstar Games utilized aspects of the spaghetti Western, and paid homage to it in their Red Dead Redemption series, as well as in its predecessor, Red Dead Revolver.