Pintilie had a tremendous impact on the Romanian culture, both in cinema and theatre. He made his first feature film Sunday at 6 / Duminică la ora 6 (produced by Studioul Cinematografic București) in 1965 and he continued with Reconstruction / Reconstituirea (1972, Studioul Cinematografic București), voted by the Romanian film critics as the most important Romanian film of all time. In 2012 Reconstruction was bought by MoMA New York for its permanent collection.

Clashes with the communist censorship forced him to leave the country in 1972. He lived in France for a few years and returned to Romania in 1979 to shoot Why Are the Bells Ringing, Mitică? / De ce trag clopotele, Mitică? (Studioul Cinematografic București), which was released only after the fall of the Communism.

He also directed The Oak / Balanța (1992), An Unforgettable Summer / O vară de neuitat (1994) starring Kristin Scott Thomas and Too Late / Prea târziu (1996), which were both selected for Cannes’ Competition, Terminus Paradis (awarded with the Special Jury Prize in Venice in 1998), The Afternoon of a Turturer / După-amiaza unui torționar (2001, also selected for the Venice Competition), Niki and Flo / Niki Ardelean, colonel în rezervă (2003).

After 1990 Pintilie established his own production company, Studioul de Creație Cinematografică al Ministerului Culturii, which produced most of his films together with Filmex Film. Also most of his films made after 1990 were Romanian/French coproductions and were coproduced by the Romanian-born French producer Marin Karmitz through MK2 Productions.

His work and personality impacted all the important directors of the New Romanian Cinema. They all claim to have been inspired by him.

He had an even more notable impact on the world of theatre, directing productions at leading international companies, helping to change the shape of American theatre in particular through his critically acclaimed productions at companies such as the Guthrie Theatre.