Aronofsky followed his debut with Requiem for a Dream, a film based on Hubert Selby, Jr.'s novel of the same name.
The Wrestler premiered at the 65th Venice International Film Festival.
Initially receiving little attention, the film wound up winning the Golden Lion, the highest award at the world's oldest film festival.
Aronofsky's sixth film, the biblically inspired epic Noah, was released in theaters on March 28, 2014.
Noah grossed over $43.7 million during its opening box office weekend, becoming Aronofsky's highest opening weekend and his first film to open at No.1.
Rourke won a Golden Globe, as did Bruce Springsteen for his original song written for the film.
The Wrestler grossed ,674,354 worldwide on a budget of ,000,000 making it Aronofsky's highest-grossing film to that point.
I have so much respect for Nic Cage as an actor and I think it really could have worked with Nic but, you know, Nic was incredibly supportive of Mickey and he is old friends with Mickey and really wanted to help with this opportunity, so he pulled himself out of the race." Cage responded, "I wasn't quote 'dropped' from the movie.
I resigned from the movie because I didn't think I had enough time to achieve the look of the wrestler who was on steroids, which I would never do".
Production was postponed to wait for a pregnant Blanchett to give birth to her child in December 2001.