His father was a neurosurgeon who treated the Aga Khan and provided the inspiration for the poem "Disease", for which Hamilton-Paterson was awarded the Newdigate Prize.
He was educated at Windlesham House, Sussex, Bickley Hall, Kent, King's School, Canterbury and Exeter College, Oxford.
His novel Ghosts of Manila (1994) portrayed the Philippine capital in all its decay and violence and was highly critical of the Marcoses – a view he rescinded with the publication of America's Boy (1998), which sets the Marcos regime into the geopolitical context of the time.
In 1989, Gerontius was published, a reconstruction of a journey made by the composer Sir Edward Elgar along the River Amazon in 1923.
More recently he won acclaim for his Gerald Samper trilogy as well as his non-fiction book Empire of the Clouds, which details the aviation industry in post-war Britain.