[17] On April 16, 2009, Altidore underwent minor surgery on an injured toenail that required more than a month of recovery, resulting in him never making an appearance for Xerez.

[22] Altidore was popular with supporters but struggled to make a lasting impact with the Tigers as his finishing was often found wanting, however he did manage to score his first and only Premier League goal in the 2–1 home win over Manchester City on February 6.

[23] On April 24, in an important game for Hull City's Premier League survival, he was dismissed for violent conduct after a spat with Sunderland's Alan Hutton who was also sent off.

After a goalless first-half, Altidore opened the scoring in the 54th minute, pouncing on the rebound after NEC goalkeeper Jasper Cillessen saved his header.

[32] Altidore added to his Europa League account when he opened the scoring in the 21st minute of his side's first group match against Malmö FF on September 15.

[39] In the opening game of the new Eredivisie campaign, Altidore scored a quick brace as AZ drew 2–2 with reigning champions Ajax on August 12, 2012.

[40] Altidore continued his impressive start to the league campaign, netting another brace in the club's 3–1 victory over SC Heracles on the second weekend of the season.

[46] Subsequently, Altidore became the first-ever American to be named in De Telegraaf's "Team of the Season" after finishing with 23 goals in the Eredivisie and 8 in the KNVB Cup.

[56] His former MLS side, the New York Red Bulls, were the league's preferred destination for Altidore, but Toronto was unwilling to accept the cash settlement required to complete the move.

[62] Altidore came close to his first piece of silverware with Toronto in May, scoring the opening goal in a 3–2 victory against the Montreal Impact in the second leg of the Canadian Championship semifinals.

[69][70] Despite not starting in the 2–1 win against the New York Red Bulls, Altidore was dismissed as a substitute after directing foul and abusive language at a fourth official.

[71] Helping Toronto advance to the 2015 MLS Cup Playoffs, Altidore played 90 minutes but failed to register a shot as his side fell 3–0 at the Montreal Impact.

After a missing a penalty in a 4–3 defeat to Vancouver Whitecaps FC in May, he finally broke his deadlock with an 87th-minute strike in a 3–0 win over Columbus Crew on July 31.

[82] Sending Toronto to the 2016 MLS Cup Playoffs, he struck his side's third and final goal in a victory against the Philadelphia Union to progress to the Eastern Conference semi-finals.

[86][87] Toronto reached the MLS Cup Final for the first time in their history, but lost to Seattle Sounders FC on penalties after a goalless game.

Ahead of the 2017 MLS season, the arrival of Spanish playmaker Victor Vázquez, and Coach Greg Vanney's switch in tactics from a 4–4–2 diamond to a 3–5–2 formation, benefitted Giovinco's and Altidore's attacking partnership, as it allowed them to play closer together; with Vázquez supporting them as the team's main creator, the attacking duo began to demonstrate a deeper understanding and an increased awareness of each other's movements, which improved their link-up play, and saw an increase in Altidore's goalscoring output throughout the season.

[102] Altidore also scored in the final two league fixtures, against the Montreal Impact and Atlanta United FC, as Toronto clinched the 2017 Supporter's Shield with a record-breaking 69 points.

[105][106][107] Progressing to the MLS Cup Playoffs for a third consecutive season, Altidore was involved in two controversial incidents against former club the New York Red Bulls in the Eastern Conference semi-final second leg.

He was subsequently shoved by New York's captain, Sacha Kljestan, and fell to the ground in an exaggerated manner; both players were cautioned by referee Chris Penso for their behaviour.

[113] On March 7, 2018, in the first leg of the CONCACAF Champions League quarter-finals, Altidore scored in a 2–1 home win against Mexican side Tigres UANL.

[118] He suffered an injury in the seventh minute of the second leg, on April 10, at the Estadio Azteca, and was replaced by Tosaint Ricketts; the match ended in a 1–1 away draw, which saw Toronto advance 4–2 on aggregate to the finals.

[122] On August 12, he was sent off after only 11 minutes in a 3–2 home defeat against New York City FC, after allegedly kicking defender Alexander Callens in the back of the leg.

[123] On August 15, in the second leg of the 2018 Canadian Championship Final, Altidore scored a hat-trick in a 5–2 home win over Vancouver Whitecaps to seal the title for Toronto with a 7–4 victory on aggregate.

[124] On November 10, 2019, Altidore, having recently recovered from a quadriceps strain, came off the bench and scored an injury-time header in a 3–1 away defeat to Seattle Sounders in the 2019 MLS Cup Final.

[132] On June 24, 2009, Altidore scored in the semi-final of the 2009 FIFA Confederations Cup against Spain, turning club teammate Joan Capdevilla to get a clear shot on Iker Casillas' goal.

On June 16, 2014, in the United States' opening 2014 FIFA World Cup match against Ghana, Altidore injured a hamstring and had to be carried from the field.

[142] On March 31, 2015, Altidore received his first international red card for verbally abusing referee Luca Banti in an eventual 1–1 friendly draw against Switzerland in Zürich.

His height, strength, and ability in the air also enable him to hold up the ball with his back to goal and act as a target forward; he is also capable of playing on the wing, or as a second striker.

[150] In honor of the 26 victims of the Sandy Hook Elementary School shooting a week earlier, Altidore wrote their names on the boots he wore in the game against FC Twente on December 21, 2012.

[153] Altidore is part of a consortium that included Tracy McGrady, Vince Carter and a coalition of private equity funds and executives who purchased a 20% stake in the Buffalo Bills of the National Football League in December 2024.