[1] In 2016, the Portuguese Handball Federation appointed him as the new head coach of the Portugal national team, succeeding Rolando Freitas.

[2][3][4] He is best known for transforming the Portugal national team into a competitive force on the international stage, leading them to a 6th-place finish at the 2020 European Men's Handball Championship,[5] and their first-ever appearance at the 2021 Tokyo Olympics, where they placed 9th.

[8] Building on this historic achievement, Portugal delivered one of the tournament’s most remarkable performances, with three of its players earning spots in the 2025 IHF Men’s World Championship All-Star team—comprising nearly a third of the prestigious 10-player selection:[9][10] In recognition of his historical achievements, Paulo Pereira won the title of “Coach of the Year”[11] at Sports Gala organized by the National Sports Federation.

In 2009, he became Angola's national head coach, leading the team to victory in the 2010 Women's Handball Africa Championship.

[17] In 2016, the Portuguese Handball Federation named him the new head coach for the Portugal national team, then extended his contract until the summer of 2023.