She became head of Continental Air Services, Inc in Cambodia, which flew regularly between Phnom Penh and Bangkok on behalf of the U.S. Embassy and other organizations.
He described her as a "small, sparky, tough, brown-eyed provincial Frenchwoman" with "an absolutely non-negotiable, visceral requirement...to get food and money to the starving, medicines to the sick, shelter for the homeless, paper for the stateless...This did not in any way prevent her from being a resourceful and frequently shameless businesswoman, particularly when she was pitched against people whose cash, in her unshakable opinion, would be better in the pockets of the needy.
Pierpaoli, along with American Lionel Rosenblatt, rescued as many refugees as possible before they were forced across the border, especially at Preah Vihear Temple, where 40,000 Cambodians were pushed off a cliff into a minefield.
Joined by several volunteers, she undertook to rebuild the houses, to dig wells and to return the land to cultivation, demonstrating that "a single person can sometimes achieve what large organizations cannot....I realized what made me different from others in how I conceptualized humanitarian work.
"[5] Pierpaoli published her autobiography Woman of a Thousand Children in 1992 and became the European Representative of Refugees International (RI) the same year.
During the 1990s, along with colleagues RI President Rosenblatt and Advocacy Director Larry Clinton Thompson, she undertook missions to humanitarian disaster areas in Mali, Niger, Bangladesh, Albania, and Southeast Asia.
On April 18, 1999, while on a mission to assist refugees from Kosovo, she was one of four people killed in an automobile accident while traveling from Tirana to Kukës, Albania.