You know you're not going to see your average stand up comedy show when you see ambulances standing by outside the venue.

But this was no ordinary show. This was Steve-O, the clown prince of Jackass and the guy who stapled his scrotum to his thigh and tattooed his own likeness on his back. Clearly, confidence and pain aren't a problem for this 36-year-old, one of the headliners of the Wild West Comedy Festival.

Winning over the crowd at the Perth Concert Hall on Thursday night wasn't a problem either. Almost all were in their 20s and 30s and had never been to the Concert Hall for the symphony, if you know what I mean. They were young, rowdy and raring to see Steve-O to abuse his body for their delight.

What they got, instead, was a crass, goofy, earnest and outrageous routine from a budding comedian using stand-up as his salvation.

Local comedian John Robertson warmed up the crowd with a fast and furious 20-minute set that included spot-on imitations of the Iron Chef judges and movie voice-overs.

Then, with a backwards cap and jeans clingingly gingerly to his bony buttocks, the former Stephen Glover celebrated being drug and alcohol free for three years and how he's gone from booze and pills to mung beans and Pilates. He seemed genuinely thankful for the chance to redeem himself through stand-up.

"You know you need help when Johnny Knoxville stages your intervention," the gangly, goofy-looking Steve-O laughed. "It was actually my fifth intervention, but I hallucinated the first four."

A stint in rehab and the "spectacular end song" that was Jackass 3D led Steve-O to seek a life after life-threatening stunts. And while he's certainly got plenty of hilarious stories to tell, it's clear he also has the charisma and stage command to make it - post-Jackass - on his own.

Yes, his mostly filthy routine is filled with filthy anecdotes, from his favourite masturbatory websites to hilarious encounters with strippers. His re-enactments, gestures and facial expressions show a gift for physical comedy. But it was his more earnest stories - such as living in his car for eight months in LA - that gave his show real heart.

Having proven his natural talent for stand up, it was both ironic and a bit, well, sad that Steve-O felt the need to finish his 75-minute set with a handful of Jackass style party tricks. Stunts with lemon juice, knives, glass and fire all gave the crowd what they came to see. But they weren't necessary.