He qualified in medicine in Italy in 1983. In 1985, following his early clinical training, he came to the UK as a Research Fellow to the Department of Rheumatology at Guy's Hospital. Here he started his academic career carrying out research in rheumatoid and psoriatic arthritis for four years that lead to a PhD at the University of London.
He then went back to full time clinical training in general medicine in the UK, gaining the MRCP in 1992. He returned to the Department of Rheumatology at Guy's in 1993 as the Arthritis Research Campaign Lecturer/Senior Registrar. In 1996, he was awarded a Senior Lectureship-Career Development Award by the Wellcome Trust and in 2000 he was conferred the Chair of Experimental Rheumatology at King's College London School of Medicine.
In May 2007 Professor Pitzalis was recruited to Barts and The London School of Medicine to head the new Centre for Experimental Medicine and Rheumatology. In July 2008 he was appointed Director of the Musculoskeletal Clinical Academic Unit by Barts and the London NHS Trust combining academic and clinical duties to integrate research into service delivery to improve patient care and in compliance with Department of Health policy: “best research for best health”.
In 2016, he was appointed Deputy Director of the William Harvey Research Institute. In November 2018, he was appointed Chair of the NIHR (NOCRI) Joint & Inflammatory Related Diseases Translational Research Collaboration.