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In 1992 Birtsas pitched for the Rimini Pirates in the Italian Baseball League, and won two games of the championship series, including a shutout in the third and decisive game, leading his team to the league title with a 3-0 sweep. After pitching in Italy, Birtsas retired due to hip problems.

With new manager Lou Piniella in place for 1990, the Reds started the season off with a nine-game winning streak, and remained in first place in the National League West for the entire season. Four of these nine games were won by relief pitchers (including one by Birtsas), who also compiled five saves. The relief corp of the Reds earned the nickname "The Nasty Boys" along the way, and lived up to this reputation by leading the National League with 46 saves, and compiling 385 strikeouts.

On June 4, Birtsas accomplished the rare feat of striking out four batters in one inning. Regardless, following a poor performance against the Atlanta Braves on June 20, Piniella seemed to lose faith in Birtsas. Birtsas saw little work in key situations in the second half of the season, and was optioned down to triple A toward the end of July. He was recalled in September, and was part of the Reds' post-season roster, but did not make an appearance in the 1990 National League Championship Series with the Pittsburgh Pirates or World Series against the A's. The Reds were 0-12 in Birtsas' final twelve regular season appearances.

When the Reds re-signed second baseman Bill Doran at the 1990 Winter meetings, they released Birtsas to clear a roster spot. With no major league teams bidding on his services, Birtsas signed with the Tokyo Yakult Swallows of Nippon Professional Baseball for the 1991 season. Shortly after his arrival in Tokyo, Birtsas got into a brawl with Yoshihisa Komatsuzaki of the Chunichi Dragons when he threw a brush back pitch Komatsuzaki felt was a little too inside.

Despite the turmoil the Reds faced in 1989 with manager Pete Rose's betting fiasco, Birtsas managed to put together a respectable season. He made a career high 42 appearances, and went 2-2 with a 3.75 ERA while earning his only career save, a rare four inning save, against the San Francisco Giants on August 7. He also got his only career hit in eighteen career at-bats on July 2, a home run off the New York Mets' Sid Fernandez.

After splitting the 1987 season between Tacoma and double A Huntsville, Birtsas was again packaged with José Rijo, this time to the Cincinnati Reds for Dave Parker.

Birtsas was slated to be one of two left handers out of the Athletics' bullpen for the 1986 season. He allowed five earned runs on two hits (including a grand slam by Brian Downing) and three walks in just one inning in his first appearance of the season. Knee problems were cited as a potential cause of his ineffectiveness. After one more appearance, he was optioned down to triple A Tacoma to "get his groove back." He spent the rest of the season at Tacoma, going 3-7 with a 5.07 ERA, used mostly as a starter.

After going 12-8 with a 2.36 earned run average with the Fort Lauderdale Yankees in 1983, Birtsas' 1984 season was delayed by a leg injury in spring training. Once activated, he went 5-1 with a 3.59 ERA in ten starts to help his team win the Florida State League championship. After the season, he was packaged with Jay Howell, Stan Javier, José Rijo and Eric Plunk in a trade to Oakland for Rickey Henderson.

Birtsas earned All-County and All-League honors pitching for Clarkston High School in Independence Township, Michigan. He also played varsity basketball, but it was baseball that earned him a scholarship to Michigan State University. Under legendary coach Danny Litwhiler, he was a second-team All Big Ten Baseball Team selection in 1982 and received the Steve Garvey Sportsmanship Award. He also majored in Recreation and Youth Leadership with an emphasis on children with special needs at MSU.

The New York Yankees did not have a first round selection in the 1982 Major League Baseball draft. With the 36th overall pick, in the second round, they selected Birtsas.

Timothy Dean Birtsas (born September 5, 1960), is a former Major League Baseball pitcher. Though history remembers the "Nasty Boys" as a trio, according to Rob Dibble, Birtsas' name should be included when talking about the famed 1990 World Series winning Cincinnati Reds' bullpen.