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After representing Spain at under-19 and under-21 levels, Fabián was called up to the full side by manager Luis Enrique on 15 March 2019, for two UEFA Euro 2020 qualifying matches against Norway and Malta.

He made his debut on 7 June 2019 in an Euro 2020 qualifier against Faroe Islands, as a 74th-minute substitute for Isco.

On 30 April 2018, Fabián scored the winning goal for Betis as they secured UEFA Europa League qualification for the 2018–19 season following a 2–1 home win over Málaga CF.

On 5 July 2018, Fabián joined S.S.C. Napoli on a five-year contract until 2023 with Napoli reportedly paying Fabián's €30 million buyout clause. He made his debut on 16 September in a Champions League group game away to Red Star Belgrade, playing the full 90 minutes of a goalless draw. Ten days later he played his first Serie A match and first at the Stadio San Paolo, a 3–0 win over Parma Calcio 1913.

On 23 December of the following year he renewed his contract until 2019, and was immediately loaned to Elche CF in the second level. He scored his first professional goal on 17 March 2017, netting the first in a 3–1 away win against Gimnàstic de Tarragona.

Upon returning, Fabián became a regular starter under new manager Quique Setién, scoring his first goal in the top tier on 25 September 2017 in a 4–0 home routing of Levante UD. The following 31 January, he renewed his contract until 2023, setting his buyout clause at €30 million.

Fabián made his debut in the main category of Spanish football on 23 August 2015, coming on as a substitute for Alfred N'Diaye in a 1–1 home draw against Villarreal CF.

Fabián played his first match as a professional on 16 December, replacing Xavi Torres in the 51st minute of a 1–0 Segunda División away win against CD Lugo. He appeared in six matches during the season, as his side achieved promotion to La Liga as champions.

A left-footed central midfielder, Ruiz is known for his vision, passing, ball control and dribbling skills, as well as his tactical versatility, and can play in a number of formations, such as 4–4–2, 4–3–3, and 4–2–3–1. He can also play as a defensive midfielder or an attacking midfielder.

Born in Los Palacios y Villafranca, Seville, Andalusia, Fabián joined Real Betis' youth setup in 2004, aged eight, after starting it out at EF La Unión de Los Palacios. He was promoted to the reserves in July 2014, and made his senior debut on 21 September, coming on as a second half substitute in a 1–4 home loss against Marbella FC for the Segunda División B championship.

Fabián Ruiz Peña (Spanish pronunciation: [faˈβjan rwiθ ˈpeɲa] ; born 3 April 1996), simply known as Fabián, is a Spanish professional footballer who plays for Italian club Napoli and the Spanish national team.