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On January 24, 2019, the New York Yankees signed Ottavino to a three year contract worth $27 million. Ottavino is the first Yankee in team history to wear number 0, the last single digit number available by the Yankees.

After closer LaTroy Hawkins struggled to open the 2015 season, Ottavino was named the new closer. On May 4, 2015, it was revealed that Ottavino had a partially torn ulnar collateral ligament in his right elbow, which required Tommy John surgery, ending his 2015 season.

After the 2015 season, the Rockies and Ottavino agreed on a three year contract worth $10.4 million. Ottavino began the 2016 season on the disabled list. After returning, he completed 37 scoreless appearances, in 31 innings pitched, which set a Rockies' franchise record. In 2018, he was 6–4 with a 2.34 ERA, and shared the major league lead in holds, with 34.

In 2013, Ottavino switched his uniform number to 0. Despite posting a 5–1 win-loss record, his earned run average (ERA) was close to 5 in 79 innings. In 2013, Ottavino appeared in 51 games, pitching in 78.1 innings and lowering his ERA from the previous season by 2 runs, registering an ERA of 2.64 for the Rockies. In 2014, Ottavino went 1–4 with a 3.60 ERA in a career high 75 games.

On April 3, 2012, the Colorado Rockies claimed Ottavino off of waivers. The Rockies assigned him to the Colorado Springs Sky Sox of the PCL. They promoted him to the majors later that season, and developed him into a relief pitcher.

After the 2009 season, the Cardinals added Ottavino to their 40-man roster. He began the 2010 season with Memphis. On May 29, 2010, Ottavino made his major league debut for the Cardinals as a starter. He appeared in five games for the Cardinals in 2010, three of them starts. After the 2010 season, the Cardinals outrighted Ottavino off of their 40-man roster. He pitched for Memphis in 2011, and the Cardinals readded him to their 40-man roster after the season.

The St. Louis Cardinals selected Ottavino out of Northeastern University in the first round, with the 30th overall selection, of the 2006 MLB draft. That year, he pitched for the Swing of the Quad Cities of the Class A Midwest League. He pitched for the Springfield Cardinals of the Class AA Texas League in 2008. In 2009, Ottavino pitched for the Memphis Redbirds of the Class AAA Pacific Coast League (PCL). He had an 0–9 win-loss record in the first half of the season, but had a 7–3 record in the second half.

Ottavino enrolled at Northeastern University, where he played college baseball for the Northeastern Huskies baseball team. Ottavino holds both the Northeastern career and single season records for strikeouts. In 2005, he was named America East Conference's Pitcher of the Year. After the 2005 season, he played collegiate summer baseball with the Harwich Mariners of the Cape Cod Baseball League.

A native of New York City, Ottavino was born in Manhattan and moved to Brooklyn when he was 3. He attended elementary school at P.S. 39, The Henry Bristow School in the Park Slope neighborhood of Brooklyn, junior high school at I.S. 240 Andreas Hudde and graduated from the Berkeley Carroll School in Park Slope in 2003. The Tampa Bay Rays selected Ottavino in the 30th round of the 2003 MLB draft, but he did not sign.

Adam Robert Ottavino (born November 22, 1985) is an American professional baseball pitcher for the New York Yankees of Major League Baseball (MLB). He previously played for the St. Louis Cardinals in 2010 and the Colorado Rockies from 2012 to 2018.