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Peschisolido represented his country from U-16 level upwards to the senior level spanning from 1986–2004, making his senior debut for the Canadian national team in 1992. He went on to play 53 times for Canada, scoring 10 goals, in a 12-year senior international career. On 1 June 2013, he was inducted into the Canadian Soccer Hall of Fame.

On 15 January 2009, he was appointed as Jeff Kenna's assistant manager at League of Ireland club St Patrick's Athletic. Both Kenna and Peschisolido registered as players for the 2009 season in case of emergency. On 15 May 2009, he resigned from this post for "personal reasons" with immediate effect.

Three days later, on 18 May 2009, he was appointed manager of Burton Albion taking over from caretaker manager Roy McFarland, who had taken the club to promotion to League Two after the departure of Nigel Clough. Peschisolido was in charge of Burton for almost 3 years but was relieved of his duties on 17 March 2012, following a winless run of 14 games.

On 16 July 2007 Peschisolido signed for Luton Town on a one-year deal. He played just four league matches and one cup match for Luton, scoring once in the Football League Trophy against Northampton Town, before an ankle problem kept him out of action from September onwards. After the injury failed to respond to injections it was confirmed in December that he would require an operation, ruling him out for the rest of the season. Luton released Peschisolido at the end of the 2007–08 season, following their relegation to League Two. Failing to fully recover from injury, he would subsequently retire and not seek a new club. By this time, he had accumulated 447 Football League appearances and 118 goals over 16 years, predominantly in the second tier of English professional football. He also made 76 cup appearances, scoring 22 goals.

In March 2004, Peschisolido joined Derby County in a swap deal, with Izale McLeod moving to United on loan for the rest of the season. Once again he scored on debut, contributing four goals in his first three appearances, including two against local rivals Nottingham Forest, one of which was gifted to him by goalkeeper Barry Roche, who sliced an attempted clearance after the ball deflected off a plastic coffee cup on the pitch. After Derby avoided relegation in 2004, Peschisolido's "knack for scoring vital goals from the substitutes' bench" helped them reach the playoffs in 2005 and 2007, though he started in the playoff final against West Bromwich Albion at Wembley Stadium, which Derby won 1–0 to earn promotion to the Premier League. Peschisolido was released by the club at the end of that season.

He later re-joined Sheffield United in a permanent deal for £250,000, after agreeing to a wage cut. He was a key player in the 2002–03 season, helping the club reach the semi-finals of the 2003 FA Cup and League Cup and the Division One play-off final. In the play-off semi-final against Nottingham Forest, Sheffield United came back from a two-goal deficit to take the game into extra time. Peschisolido came off the substitutes' bench at the midpoint of added time to score the goal that took the lead, which is remembered not just for its impact on the game but also for the player's frantic celebrations afterwards. In the 2003 FA Cup semi-final against Arsenal, he was denied an equalising goal by goalkeeper David Seaman, who made a one-handed "claw-back" save from Peschisolido's header which three-time Best European Goalkeeper Peter Schmeichel later described as "the best stop I’ve ever seen in the flesh".

After appearing in two League Cup matches for Fulham in the 2000–01 season, Peschisolido was loaned to Queens Park Rangers in November 2000. He scored on his QPR debut, playing alongside the much taller Peter Crouch in a 1–1 draw against Portsmouth. In January 2001, he went on loan again, this time to Sheffield United, also scoring on his debut for "the Blades", before spending a further loan period at Norwich City.

After 51 appearances and 21 goals for West Brom, he dropped down a division to join Fulham in October 1997, for a £1.1 million transfer fee. He appeared 37 times for 'the Cottagers' in the 1997–98 season, scoring 13 goals and helping the team win promotion as Division Two champions. In the next two seasons, he produced 10 goals from 40 appearances and 7 from 36 appearances in all competitions.

Peschisolido signed for West Bromwich Albion in a £600,000 deal in July 1996. He made his first appearance for the club in the 3–1 home League Cup defeat to Colchester United on 3 September 1996. Four days later, Peschisolido scored just nine minutes into his Albion league debut, as the Midlands side ran out 2–0 winners at Queens Park Rangers. He was joint top League scorer that season for the club.

In 1995, Peschisolido married Karren Brady, who was at the time managing director of Birmingham City F.C. The couple have two children, daughter Sophia and son Paolo. Peschisolido is a cousin of former National Hockey League (NHL) player Mike Ricci.

In August 1994, he moved on to Stoke City in a £400,000 plus player exchange deal involving Dave Regis. He was top scorer with 15 goals for the 1994–95 season, and remained at Stoke until March 1996, when he returned to Birmingham until the end of the 1995–96 season, scoring once in nine appearances.

After spending a year with the Juventus academy, returning homesick saw him offered the opportunity from his former national youth team coach Tony Taylor to join Birmingham City for £25,000 in November 1992. He was joint top scorer in each of his two seasons with the club.

He made his senior national team debut for Canada on 13 June 1992 in a match against Hong Kong at Varsity Stadium where he scored his first international goal. Peschisolido formed effective striker partnerships for Canada with Alex Bunbury and Carlo Corazzin over their years with the national team. Peschisolido scored the majority of his international goals between 1995–1996 at Commonwealth Stadium that included a number of World Cup qualification matches which led to the venue becoming lovingly nicknamed St. Paul's Cathedral amongst the Canadian fans and press. He scored his last international goal on his 50th cap on 13 June 2004 in a World Cup qualification match against Belize, exactly 12 years to the day from his first international goal and first cap. He earned a total of 53 caps from 1992–2004, and scored 10 goals making him tied 9th with Tomasz Radzinski in all time scoring for Canada. He represented Canada in four FIFA World Cup qualification campaigns (1994, 1998, 2002, and 2006) in 26 FIFA World Cup qualification matches He played in the Canadian squad that won the 2000 CONCACAF Gold Cup and played in all of Canada's three games at the 2001 FIFA Confederations Cup. His final international cap was on 4 September 2004 at Commonwealth Stadium in a World Cup qualification match against Honduras.

Born in Scarborough, Ontario, Canada, Peschisolido began his professional playing career when still a high-schooler with Archbishop Denis O'Connor Catholic High School in Ajax. He led the team to OFSAA finals in his last year then moved on as a trainee with the Toronto Blizzard of the Canadian Soccer League, where he was named the "Rookie of the Year" in 1989. He also played the 1990–91 Major Indoor Soccer League season with the Kansas City Comets, being named the league's 'Newcomer of the Year'.

Peschisolido played in all of Canada's three games at the 1987 FIFA U-16 World Championship which were held in Canada. He earned 7 caps at the U-17 level, 6 caps at the U-20 level scoring 2 goals, and 12 caps at the U-23 level scoring 5 goals.

Paolo Pasquale Peschisolido (born 25 May 1971), commonly known as Paul Peschisolido, is a Canadian soccer manager and former player, and husband of Karren, Baroness Brady. Peschisolido was manager of English League Two club Burton Albion from May 2009 until March 2012, when he was dismissed following a poor run of games which left his side 17th in the league.