His career in theater, opera, film and television has gained him international recognition. From 1960 to 1972 he was resident director at the Bulandra Theatre in Bucharest, Romania. His productions there included George Bernard Shaw's Cesar and Cleopatra, Lorraine Hansberry's A Place in the Sun, William Saroyan's My Heart's in the Highlands, Max Frisch's Biedermann and the Firebugs, Nikolai Gogol's Inspector General and Anton Chekhov's Cherry Orchard. He also directed the Romanian classic comedy Carnival Scenes by Ion Luca Caragiale which won the 1967 Prize for the best direction and best production at the National festival of theater in Romania. From 1973 to 1982 he directed mainly in France at the Théâtre national de Chaillot and the Théâtre de la Ville where he staged, among other plays, Carlo Gozzi's Turandot, Henrik Ibsen's Wild Duck, and Anton Chekhov's Three Sisters and Seagull. In France, he directed also several operas including a production of Oresteia by Aurel Stroe, based on the Greek tragedy, at the Festival in Avignon and Mozart's Magic Flute at the Festival in Aix-en-Provence. He also directed Bizet's Carmen for the Welsh National Opera of Cardiff, Wales. His films brought him international reputation. Sunday at Six o Clock won the Prize of the Jury at the International film festival in Mar del Plata, Argentina in 1966, and the Grand Prize of the Jury at the International Encounter of Films for Youth at Cannes, France in 1967. In 1968, he produced The Reconstruction considered by film historians to be the most important representation of Romanian cinema. In 1975 he filmed for Yugoslavian television Ward Number 6, his own adaptation of Chekhov's famous story. It won the Catholic Film Office Prize at the Cannes film festival. In the United States, in addition to his work at the Guthrie Theater in Minneapolis, Pintilie staged Tartuffe and The Wild Duck at Arena Stage.
His best-known films are “Paviljon VI” (1978), "The Oak" (1993), “An Unforgettable Summer” (1994), “The Afternoon of a Torturer” (2001) and “Niki and Flo” (2003).