[11] After a competition in spring training, the Orioles named Means to the team's Opening Day roster as a relief pitcher for the 2019 season.

[13] On June 28, 2019, Means was selected to his first All-Star Game, his 2.50 ERA ranking second among American League pitchers for the first half of the season.

His only baserunner, Sam Haggerty, reached on a dropped third strike in the third inning and was subsequently caught trying to steal second base.

[23] Means was named the Opening Day starter for the 2022 season,[24][25][26] and pitched on April 7 against the Tampa Bay Rays.

[31][32] Doctors determined that Means needed Tommy John surgery, which prematurely ended his 2022 season.

The Orioles activated him from the injured list on September 12, 2023, and he pitched the first five innings in a 5–2 home loss to the St. Louis Cardinals later that same night.

[36][37] Means earned his first win in two years two starts later in a 2–1 road victory over the Cleveland Guardians on September 23 in which he pitched 8+1⁄3 innings including the first 7+2⁄3 without allowing a hit.

[38] After missing a short time in 2024 due to injury, Means returned to make four starts and compile a 2.61 ERA with 16 strikeouts across 20+2⁄3 innings pitched.

[39] On June 3, Means underwent Tommy John surgery for the second time, effectively ending his season.

Alan was the Local 41 (Kansas City, Missouri) Secretary/Treasurer just before his death from pancreatic cancer at age 57 on August 5, 2020.