On July 20, 2020, Judge Valerie Caproni sentenced Silver to 78 months in prison and fined him $1 million as a result of his prior convictions. Caproni denied Silver's request to serve a home sentence due to health concerns amid the coronavirus pandemic.

On May 11, 2018, Silver was found guilty of federal corruption charges for the second time. Prosecutors argued that Silver had arranged for Columbia University cancer researcher Robert Taub to receive two $50,000 from the state Health Department and, in exchange, Taub referred approximately 50 cancer patients with legal claims to the firm Weitz & Luxenberg. Silver allegedly received a portion of the firm's legal fees. Prosecutors also argued that Silver received a portion of legal fees from the law firm Goldberg & Iryami after getting two real estate developers, Glenwood Management and the Witkoff Group, to become clients. The jury found Silver guilty on seven counts, including two counts of honest services fraud, one count of extortion, and one count of money laundering. Silver's attorney denied that there was evidence of bribery and said he planned to appeal the verdict.

On July 13, 2017, Silver's 2015 conviction was overturned by the United States Court of Appeals for the 2nd Circuit. The three-judge panel cited a 2016 decision by the U.S. Supreme Court that overturned the conviction of former Virginia Gov. Bob McDonnell (R). The 2016 ruling narrowed the definition of what it takes to convict public officials of wrongdoing. The appeals court determined that the judge's instructions in Silver's 2015 trial were not consistent with the 2016 Supreme Court decision.