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He went undrafted in the 2017 NBA draft, but joined the Charlotte Hornets for the 2017 NBA Summer League.

On July 28, 2017, Karnowski agreed to terms with Spanish Liga ACB team MoraBanc Andorra. On July 8, 2018, Karnowski part ways with MoraBanc Andorra. On August 16, 2018, he signed with Twarde Pierniki Toruń of the Polish Basketball League.

On May 24, 2016, Gonzaga announced that Karnowski had received a medical redshirt and would return to the school for one final college season in 2016–17. In his final season with Gonzaga he led Gonzaga to the best start in the history of the organization (29-0) whilst posting the best offensive and defensive numbers of his career: 12.4 points, 5.8 rebounds, 2.0 assists and 0.9 block in just 22.5 minutes per game coming to the tournament. On February 2, 2017 Karnowski became the career leader in wins for Gonzaga, passing Kevin Pangos and Kyle Dranginis (both 122 wins). Following the game with BYU, Karnowski became the active leader in Division I basketball games played with 143, passing Nigel Hayes (Wisconsin), Nate Britt and Isaiah Hicks (both North Carolina). Karnowski would be surpassed later that season by Hayes and Duke's Amile Jefferson, and passed both in a win in Gonzaga's Final Four matchup with South Carolina. After the 2017 West Coast Conference Men's Basketball Tournament, Karnowski became the NCAA's career leader in wins with 132, passing Shane Battier (131). During his senior season he was nominated to the Kareem Abdul-Jabbar Award and Senior CLASS Award.

Karnowski graduated with Bachelor of Education in Sport Management and MBA with one of the highest GPAs in WCC, for which he was named to the 2016-17 WCC Men's Basketball All-Academic Team. With 13 points performance and two crucial baskets he led his team to a 77-73 victory in the NCAA tournament semifinal, giving the Gonzaga Bulldogs their first ever appearance in the NCAA March Madness Final.

Karnowski represented the senior Polish national basketball team at EuroBasket 2013, in Slovenia. He averaged 3.3 PPG, 2.5 RPG, and 0.3 APG.

Przemek narrowed his decision down to California and Gonzaga. He committed to Gonzaga on May 29, 2012. For his freshman season he was behind star Canadian center Kelly Olynyk, a future lottery pick in the 2013 NBA draft. In the 2013-14 season Karnowski averaged 10.4 points, 7.0 rebounds and 1.7 blocks per game as the Bulldogs' starting center. As a junior, he averaged 11 points, 5.8 rebounds and 1 block per game. Due to back problems, Karnowski had surgery after playing only five games in his senior season. He was averaging 8.8 points and 5.4 rebounds in those five games.

In the 2011–12 season, Karnowski played for Siarka Jezioro Tarnobrzeg of the Polish PLK. In 35 games, he averaged 10.1 points, 4.4 rebounds and 1.2 blocks per game. After the regular season, Karnowski won the PLK Rookie of the Year Award.

Karnowski guided the Polish junior national team to the championship game of the 2010 FIBA Under-17 World Championship, in Hamburg. He was named to the All-Tournament Team. and was named Best Center of the tournament by Eurobasket.com after averaging 14.5 points, 11 rebounds, 2.5 assists and 2.0 blocked shots per contest. Joining him on the official All-Tournament Team was Canada's Kevin Pangos who would later be his teammate at Gonzaga.

Przemysław Marcin "Przemek" Karnowski (Polish pronunciation: [ˈpʂɛmɛk karˈnɔfskʲi] ; born 8 November 1993) is a Polish basketball player for Twarde Pierniki Toruń of the Polish Basketball League. He completed his college career at Gonzaga University in the United States in 2017. He has also played for the Polish national team. He had been viewed by some NBA draft analysts as a potential first round pick in the 2016 draft, but chose to return to Gonzaga for his final season of college eligibility in 2016–17.