Patterson served as the Member of Parliament (MP) for the constituency of Westmoreland South Eastern from 1970 to 1980 (when he lost to Euphemia Williams of the Jamaica Labour Party) and again from 1989 to 1993.

[3] While enrolled at the Inns of Court (Middle Temple), he and several of his fellow students were to become future leaders of the countries of the developing world.

This was the beginning of a partnership which endured over the next 23 years, and allowed for an exchange of political ideas and perspectives that proved beneficial to both.

He was a campaign manager for the PNP's bid for power in the General Elections of 1972, demonstrating skill as a political organizer that played a significant role in the party's victory at the polls that year.

[3] He assumed office as Prime Minister after Michael Manley retired in 1992, at a time when the Caribbean island nation was facing the formidable challenge of securing a place in a new global order of economic liberalization and deregulation.

In the 1993 Jamaican general election, held on March 30, Patterson led the PNP to a second consecutive victory in the polls, winning 52 of the 60 seats up for grabs, defeating former prime minister Edward Seaga of the Jamaica Labour Party.

[5] In the 1997 Jamaican general election, Patterson led the PNP to a third consecutive victory, breaking the "third-term barrier".

He also ended Jamaica's 18-year borrowing relationship with the International Monetary Fund,[6] allowing the country greater latitude in pursuit of its economic policies.

In 2012, he expressed his frustration that a republic had still not come into being[8] He made international headlines in 2004 when, as Chairman of CARICOM, he led the regional organization in the decision to refuse recognition of the Gérard Latortue government in Haiti following the removal of the democratically elected Jean-Bertrand Aristide from office.

In one of his final initiatives as Prime Minister, he launched a program of radical transformation of the island's education system aimed at development of quality human capital equipped to succeed in the competitive global economy.

He is a member of the Global Leadership Foundation, an NGO composed of a number of former statesmen, ex-presidents and prime ministers founded in 2004 by former State President of South Africa and Nobel Prize laureate, the late F. W. de Klerk.

He played a seminal role in the process that marked the transition from the first steps in integration of the Caribbean region to the founding of CARIFTA and its evolution into CARICOM.

During his tenure as Jamaica's foreign minister he served as president of the ACP/EU Ministerial Council and led negotiations for the ACP group of countries with the European Community.