Gamache was drafted 290th overall, following his second season in the QMJHL, by the Atlanta Thrashers of the National Hockey League (NHL).

[citation needed] During his NHL career, he has played for the Atlanta Thrashers, Nashville Predators, St. Louis Blues, and Toronto Maple Leafs.

[citation needed] On January 5, 2008 the Maple Leafs put Gamache on waivers.

On April 24, 2010, as part of the SC Bern team, he won the Swiss League championship.

[3] On February 7, 2011, Gamache signed a two-year extension with Fribourg-Gottéron, placing him under contract with the team until 2012–13.