[1][2] Primus Tilakaratne de Silva was born on 19 September 1929 in Mahawewa, Chilaw to traditional Buddhist parents.

[3] De Silva returned to Sri Lanka and worked briefly at the Jaffna and Colombo South General Hospitals until he was appointed as consultant physician to the General Hospital, Colombo, where he served for nearly 20 years.

He was also one of the first physicians in the country to perform gastrointestinal endoscopy, which at that time was practiced almost exclusively by surgeons.

De Silva was one of the founding members of the Board of Study in Medicine of the PGIM.

[8] In 1998, he was awarded the national titular honour Deshabandu by the President of Sri Lanka.