[1][7] He later moved back to Brooklyn and settled in Crown Heights, becoming a member of the administration of the mesivta of Yeshiva Rabbi Chaim Berlin.

[1][2] Perlow became an active member of Agudath Israel of America from 1975, when he was one of the main speakers at the 7th Siyum HaShas in New York.

[1] In December 1998, Perlow was named president of Agudath Israel of America, succeeding Rabbi Moshe Sherer, who had died seven months earlier.

[1][6] With his appointment, the presidential and leadership duties held by Sherer were divided between Perlow, the new president, and a three-man executive.

[15] In 2015, Perlow shocked attendees at the 93rd annual Agudath Israel of America dinner by directly appealing to President Obama to reconsider the Iran deal.

"[17] In June 1999, he wrote in The Jewish Observer in support of a rapprochement in the long-standing feud between the Haredi and Reform movements.

We're told that the halakha (Jewish law) is that we must listen to doctors, whether it's about a sick person or Yom Kippur".

The elder of the two, Rabbi Yehoshua Heshel "Reb Shia" currently leads his father's synagogue in Borough Park, while Rabbi Alter Yisroel Shimon "Reb Yisruel" leads the Novominsk shteeble in Lakewood, New Jersey.