Narduzzi is the son of Bill Narduzzi, who was the head coach at Youngstown State University from 1975 to 1985. Pat played football for his father in 1985 as a freshman. Narduzzi is married and has four children.

Narduzzi began his career at Miami University in 1990 where he was a graduate assistant in 1990 and 1991 and where he tutored the wide receivers in 1992. From 1993 to 1999 Narduzzi coached at the University of Rhode Island coaching the linebackers from 1993 to 1997 and as the defensive coordinator from 1998 to 1999. From 2000 to 2002, he served as the linebackers coach at Northern Illinois University. He was defensive coordinator at Miami University in 2003 before joining the University of Cincinnati staff as defensive coordinator in 2004.

Narduzzi became the defensive coordinator at the University of Cincinnati in 2004, and left in 2007 to coach at Michigan State University. Narduzzi was a candidate for the head coaching position at Cincinnati, but Central Michigan University head coach Brian Kelly was named to the post on December 3, 2006. Narduzzi had informed University of Cincinnati officials that if he was not offered a permanent head coach position, he would follow Mark Dantonio to Michigan State University as defensive coordinator.

Narduzzi was brought along by Dantonio to revamp the depleted Michigan State defense that previous coach John L. Smith left behind. Led by Narduzzi’s stingy defenses, the Spartans improved dramatically, amassing four seasons of 11 or more wins, two Big Ten Conference championships, and six victories over rival Michigan in seven years. From 2011–2014, Michigan State was the only team to rank in the FBS Top 10 in total defense and rushing defense. Narduzzi was pursued for other jobs, including as defensive coordinator at Texas A&M University and head coach at University of Connecticut. Narduzzi chose to remain at Michigan State and helped the 2012 team and the 2013 team lead the Big Ten in total defense. In 2013, he won the Broyles Award, which is given to the nation’s best assistant coach.

On December 23, 2014, Sports Illustrated reported Narduzzi would become the new head coach of the University of Pittsburgh football team. On December 26, 2014, Narduzzi was officially introduced as the 36th head football coach.

In 2015, Narduzzi led Pitt to an 8–5 record and a trip to the Military Bowl where they lost to Navy, 44–28. In 2016, Pitt recorded another 8–5 record as they went to the Pinstripe Bowl, but lost to Northwestern, 31–24. His second season was highlighted by two wins against top-five teams, a 43–42 upset win over eventual national champion Clemson and a 42–39 victory over eventual Big Ten champion Penn State.

Pitt opened 2017 with optimism over QB Max Browne but endured a tumultuous season. After struggling in a 28–21 win over FCS Youngstown State and losing 33–14 the next week to Penn State, Narduzzi’s defense faltered in a 59–21 loss to #9 Oklahoma State and a 35–17 defeat in their ACC opener to Georgia Tech. Despite wins over Duke (24–170 and Virginia (31–14), they also lost to Syracuse (27–24), #20 NC State (35–17), North Carolina (34–31), and Virginia tech (20–14). On Black Friday, Pitt shocked #2 Miami 24–14 and finished the season 5–7 (3–5 in the ACC).

In 2018, Narduzzi led Pitt to its first ACC Coastal Division title after going 6–2 in conference play and 7-5 overall. Pitt then faced Clemson in the 2018 ACC Championship Game, where they lost 42–10. Pitt went to the Sun Bowl but lost to Stanford, 14–13, to finish the season 7-7.

In 2019, Narduzzi led Pitt to another 7-5 regular season record, with a notable win over UCF, ending their 27-game regular season win streak. Pitt competed in the Quick Lane Bowl against Eastern Michigan University, winning 34-30 and earning Narduzzi his first bowl victory during his tenure at Pitt.