The Red Hot is the cured-and-smoked answer to Rochester's fresh white hot, and the curing is the entire distinction. A white hot is an uncured, unsmoked pork and veal sausage that stays pale because nothing has been done to color or preserve it; the Red Hot is a pork and beef link that has been cured and smoked, which sets its deep red color, firms its bite, and gives it the snap and smoky depth the white hot deliberately lacks. Both sit in the same buns at the same Rochester stands and the choice between them is a standing local question, but it is not a flavor preference dressed up as a name: it is a real difference in how the sausage was made, cured and smoked versus fresh, and that is what the Red Hot is.
The craft is in the cure, the smoke, and the build that frames them. The link is cured and smoked so the casing tightens to a firm snap and the meat carries a deep, smoky, slightly tangy profile, then it is grilled or flat-top cooked so the casing chars and crisps at the edges. The bun is a plain soft roll chosen to disappear and give the hand a grip, because the sausage is doing all the work and the bread should not compete. In Rochester the Red Hot most often arrives on a plate with the regional accompaniment rather than buried under toppings: a meat hot sauce, mustard, and onions, with the sauce as the savory, spiced counter that cuts the smoke and the fat of a cured link. The build is engineered around restraint so the sausage's cured character stays the headline, which is exactly the variable the white hot removes by being fresh.
The variations are mostly the choice of sauce and onions and whether it is served in a bun or as part of the plate alongside its white sibling. The Red Hot sits inside the densely argued American hot dog family, where the bun and the order of the toppings carry the regional signature and the sausage is the part everyone agrees on, alongside the Chicago dog, the coney, the half-smoke, and the Sonoran. Each of those has its own rules and its own town and deserves its own article rather than being crowded in here.