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After retiring from active play, Barrasso was an assistant coach and in charge of goaltending development for the Carolina Hurricanes for five years. In June 2012, Barrasso joined former Hurricanes coach Paul Maurice on the coaching staff at Metallurg Magnitogorsk of the Kontinental Hockey League. In 2016 he joined Asiago Hockey in the Alps Hockey League as their head coach, winning the championship during the 2017-18 season. In October 2018, Barasso left Asiago to become head coach of the Sheffield Steelers of the EIHL.

Barrasso was goaltending coach (2007–09) and later assistant coach (2009–11) of the Carolina Hurricanes. In the 2012–13 season he moved to KHL's Metallurg Magnitogorsk as assistant coach. During the Summer of 2015 Slovan Bratislava hired Barrasso as goaltending coach, but on October 31 he left the team and moved to Italy's Valpellice as head coach. The team won the Coppa Italia, but refused to join the newly founded Alps Hockey League. Barrasso, however, did not leave Italy: he moved to Asiago as head coach. Barasso was named as Head Coach of the Sheffield Steelers in the EIHL in October 2018.

In his last few seasons he briefly played for several teams, the Ottawa Senators, the Carolina Hurricanes, the Toronto Maple Leafs, and the St. Louis Blues until retiring from ice hockey in 2003. He signed a pro forma contract with Pittsburgh on the day he declared retirement so he could leave hockey as a Penguin.

Barrasso won an Olympic silver medal as part of the U.S. national men's ice hockey team at the 2002 Winter Games in Salt Lake City. He played in one game, an 8–1 victory over Belarus on February 18.

In March 2000, he was traded to the Ottawa Senators for Ron Tugnutt and Janne Laukkanen. He spent the entire 2000–01 season out of hockey and returned with the Carolina Hurricanes in time for the 2001–02 season. He enjoyed some late international success, winning Silver at the 2002 Winter Olympics.

He won the Stanley Cup twice, in 1991 and 1992. It was his play in these Cup runs that established him as a "money goalie". In the following years, Barrasso almost entirely missed two seasons, the 1994–95 NHL season and the 1996–97 NHL season with injuries but came back with good performances in the next years. In 1997, he became the first American goaltender to record 300 NHL wins. A fiercely proud competitor, in his later seasons in Pittsburgh he developed a strained relationship with the local media, who he felt were disrespectful of him and his family.

Barrasso and his wife Megan have three daughters. Barrasso founded the Ashley Barrasso Cancer Research Fund during the early 1990s after his oldest daughter survived a bout with neuroblastoma cancer.

November 12, 1988, the Sabres traded Barrasso with a 3rd round draft pick in the 1990 draft (Joe Dziedzic) to the Pittsburgh Penguins for Doug Bodger and Darrin Shannon.

Barrasso had originally intended to play for the 1984 U.S. Olympic team in Sarajevo, but chose to begin his professional career instead and left the team in September 1983 to sign with the Sabres. He made his debut for Team USA at the 1984 Canada Cup, at the age of 19. He also played in the 1983 World Junior Championships, the 1986 World Ice Hockey Championships and the 1987 Canada Cup.

Barrasso grew up in the town of Stow, Massachusetts, playing ice hockey on an outdoor rink. He started playing goaltender at the age of five years and by the time he was a teenager, was playing in net for Acton-Boxborough with fellow NHL players Bob Sweeney and Jeff Norton, Barrasso was considered one of the most promising American goaltending prospects of all time. He was drafted by the Buffalo Sabres with the 5th overall pick in 1983. Skipping a college career, he went straight from high school to the NHL. At the time of his debut with the Sabres on October 5, 1983, less than six months after graduating from high school, Barrasso was the youngest goaltender to play and win a game in the NHL since Harry Lumley nearly forty years prior. He won the Calder Memorial Trophy and Vezina Trophy in his first season, becoming the third player to win both awards in the same year.

Thomas Patrick Barrasso (born March 31, 1965) is an American professional ice hockey coach and former player. Barrasso was a goaltender for 18 seasons in the National Hockey League for the Buffalo Sabres, Pittsburgh Penguins, Ottawa Senators, Carolina Hurricanes, Toronto Maple Leafs, and St. Louis Blues. He was the only goaltender to ever play in the NHL directly from high school, without having played major junior, college, or some other form of professional hockey first. He was the youngest winner of the league's Vezina Trophy for best goaltender, as an 18-year-old rookie in 1984. He was also the youngest goaltender to win Calder Memorial Trophy, a record he still holds as of the end of 2017-18 season. Barrasso was a member of successive Stanley Cup championship teams in 1991 and 1992 with the Pittsburgh Penguins. He was inducted as a member of the United States Hockey Hall of Fame in 2009.