Moutinho began his professional career with Sporting CP, moving in 2010 to FC Porto and winning twelve major titles between the two clubs combined.

[5] After showing great promise as a boy playing for Portimonense SC, he signed with Sporting Clube de Portugal from Lisbon when he turned 13 to continue his football education.

However, he then returned to the junior team coached by Paulo Bento and featured alongside such players such as Miguel Veloso and Nani, helping the side win the national title that season.

[8] Based on consistent displays, he wasted no time in establishing himself as a regular while being able to play in any position across a flat midfield or in a diamond formation; his box-to-box dynamism and determination quickly made him a firm fan favourite, as he rarely missed a game since becoming first-choice.

[9] Moutinho's performances in the closing stages of the campaign, especially in the UEFA Cup with player of the match displays against Feyenoord[10] and Newcastle United[11] that helped the Lions reach the final of the competition, made him an automatic starter despite his young age; he contributed with 15 league games as his team finished second and, during the summer, he agreed to a one-year extension.

[12] In his first full season, Moutinho's further progress and exceptional consistency (he was the only player to play every minute of every match in the domestic league) was one of the brightest spots in Sporting's runner-up final place.

Incidentally, he scored his team's final goal of the campaign, a 1–0 win over S.C. Braga to ensure a return to UEFA Champions League football for the Lisbon side.

[28] On 19 February 2013, Moutinho scored to help his team to a 1–0 home win over Málaga CF for the Champions League round of 16, netting from close range after an Alex Sandro cross (eventual 2–1 aggregate loss).

[30] He made his official debut for his new club on 1 September, starting and setting up both goals in a 2–1 win at Olympique de Marseille which put them top of Ligue 1.

[40][41] On 23 November 2019, shortly after Moutinho had scored his team's opening goal in a 2–1 league win away to AFC Bournemouth, his second in the competition, it was announced that he had signed a new contract with the club keeping him at Molineux until 2022.

[44] He scored his first goal at Molineux, and the third of his Wolves career, from 30 yards against Arsenal in a 2–1 win on 2 February 2021, as his team did the double over the North London side in that season for the first time since 1978–79.

[52] Nine days later, he made his debut, coming off the bench during the final minutes of a 2–2 league draw at home to his former club Sporting CP, marking his return to Primeira Liga pitches after ten years abroad.

[62] Moutinho was selected by former Sporting boss Bento for the 2014 World Cup,[63] making his debut in the tournament on 16 June in a 0–4 group stage defeat to Germany.

[64] On 8 October 2015, he scored the only goal as Portugal defeated Denmark at the Estádio Municipal de Braga to seal qualification for Euro 2016,[65] and three days later was also on the scoresheet in a 2–1 win away to Serbia which confirmed his team's position as group winners.