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After graduating from Brussels University with a degree in chemical engineering and an MBA from Carnegie Mellon University in Pittsburgh, he held various positions at Abbott Laboratories Inc. and Merck and Co. Inc. He joined the Boehringer Ingelheim Group in 2003. For the first five years, he headed the Human Pharmaceuticals Division in the USA. From 2008 to 2011, he lived in Germany to lead the worldwide marketing team for human pharmaceuticals. During his tenure at Boehringer Ingelheim, the company experienced strong sales, profit and profitability growth in the USA.

From 2012 to 2018, he was Chairman of the Board of Directors and CEO of Boehringer Ingelheim USA as well as Country Managing Director for the United States. Paul Fonteyne previously served as Chairman of the National Pharmaceutical Council (NPC), and was a member of the board of Pharmaceutical Research and Manufacturers of America (PhRMA). He is currently a member of the Board of Directors of the four clinical phase biotechnology companies ResTORbio Inc, Gelesis Inc and Apellis Pharmaceuticals Inc, all based in Boston, and DalCor Inc, based in London. He also serves on the Board of Directors of AMAG Pharmaceuticals Inc. in the Boston area. He is associated as Executive in Residence with Canaan Partners (Venture Capital).