Although injuries marred his first year in the league, he was named NBA Rookie of the Year by averaging 20 points, 9 rebounds and 2 blocks per game. Very soon, he became one of the premier centers in the league. Ewing was an eleven time NBA All-Star, was named to the All-NBA First Team once, to the All-NBA Second Team six times and to the NBA All-Defensive Second Team three times. He was a member of the original Dream Team at the 1992 Olympic Games, winning a second gold medal. In 1996, he was also given the honor of being named one of the 50 greatest players in NBA history.

In 1993, it finally seemed the Knicks were on their way to the NBA Finals when they took a 2-0 lead over Michael Jordan's Chicago Bulls. However, the Bulls stunned Ewing as they won the next 4 games of the series. It was just one more ringless season Ewing had to deal with, despite the fact that the Knicks had the best record in the Eastern Conference with 62 wins and just 20 losses. He was a key contributor to the Knicks' run to the Finals in 1994, in which the Knicks lost in the final seconds of games 6 and 7 to Hakeem Olajuwon's Houston Rockets. The Knicks took Game 2 in Houston, but couldn't hold court at home, as they dropped Game 3 at the Garden. However, they won the next two games, and headed back to Houston up 3 games to 2. But a John Starks blunder, not passing at the end of game 6, and a terrible performance by Starks in game 7 was too much for the Knicks to overcome.

Patrick Ewing made the most of his appearance by setting a record for most blocked shots in a Finals series (later broken by Shaquille O'Neal). 1994 was the first year Patrick Ewing's Knicks faced a Bulls team without the Scottie Pippen-Michael Jordan duo and Scottie Pippen saw how hard it was to play without superstars (as Ewing had to his whole career) when Ewing's Knicks defeated Pippen's Bulls in 7 games in the Eastern Conference Finals. The following year, a potentially game-tying three-foot finger roll attempt by Ewing rimmed out of the basket in the dwindling seconds of game 7 against the Indiana Pacers in the Eastern Conference Semifinals. Given this opportunity, Ewing would usually simply slam dunk the ball, but the fact that the clock was winding down forced Ewing to get off a quick shot.

In 1997 Patrick Ewing suffered a potentially career ending wrist injury but worked hard to make an improbable return during the playoffs.(The Knicks returned to the NBA Finals in 1999, but Ewing missed the latter part of their playoff run due to an achilles injury, which contributed to their 4-1 loss to the taller Spurs).

In 2000, he left the Knicks, being traded to the Seattle SuperSonics. In the trade, the Knicks sent Ewing to Seattle and Chris Dudley to the Suns, and received Glen Rice, Luc Longley, Travis Knight, Vladimir Stepania, Lazaro Borrell, Vernon Maxwell, two first-round draft picks (from the Los Angeles Lakers and Seattle) and two second-round draft picks from Seattle. This is considered by many to being a major step in the downfall of the relative success of the Knicks.

After a year with the Sonics and another with the Orlando Magic, he announced his retirement on September 18, 2002. That season, he took a job as an assistant coach with the Washington Wizards.

On February 28, 2003 Patrick Ewing's jersey with number 33 was retired in a large ceremony at Madison Square Garden. Ewing continues to be considered one of the New York Knicks' finest players of all time, as well as one of the greatest in NBA history. Knicks rivalries against the Bulls, Pacers, and Heat, in which Ewing was a centerpiece, were some of the most intense of the decade. In Patrick Ewing's last year with the Knicks, he had a game winning dunk over Alonzo Mourning in game 7 of the second round of the play-offs to lead the Knicks to the Eastern Conference Semi Finals. It was a great finish to the Knicks-Heat rivalry during the Ewing years.

On August 29, 2006, Patrick Ewing resigned as an assistant coach with the Houston Rockets to spend time with his family.

As an NBA player, Ewing was renowned for his shotblocking ability, rebounding skills, thunderous dunks, and accurate mid-range jumpshot.

Ewing will be eligible for induction into the Naismith Memorial Basketball Hall of Fame in 2007.

NBA statistics
In 1999, Ewing became the 10th player in NBA history to record 22,000 points and 10,000 rebounds.

In 1993 led the NBA with 789 defensive rebounds. He was top ten in field goal percentage 8 times, top ten in rebounds per game as well as total rebounds 8 times, top ten in points, as well as points per game 8 times, and top ten in blocks per game for 13 years.