Heart of Midlothian Paterson began his career as a youth player at
Tynecastle before joining
Heart of Midlothian in 2010. A member of the club's Under-20 side he was promoted to the first team during pre-season in the summer of 2012 and made his first team debut on 14 July, in a friendly against
Raith Rovers where he scored the first goal of the game. Having impressed during these pre-season fixtures, on 4 August he made his
Scottish Premier League (SPL) debut aged 17, in a 2–0 win over
St Johnstone. He made his European debut on 23 August, in a 1–0 defeat to
Liverpool at
Tynecastle. On 31 August 2012, Paterson signed a new contract extending his stay with the club until 2015. On 22 September 2012, he scored his first two Career goals in a 3–0 win over
Dundee Utd in the
SPL. On 22 January 2013, Paterson suffered ligament damage to his foot in training that ruled him out of the
Scottish League Cup Semi-final against
Inverness that weekend. The injury required surgery and ultimately ruled him out for the remainder of the season. During his debut season Paterson made twenty seven appearances, scoring four times In doing so he played as a
right-back,
midfielder and as a
striker, with the latter being the position he played in before joining Hearts. On 11 August 2013, Paterson scored his first goal of the 2013–14 campaign, when he headed home the only goal in the
Edinburgh derby against
Hibernian at Tynecastle. On 27 April 2014, Paterson scored a brace against city rivals Hibernian in a 2–1 win. A week later he scored again in a 5–0 win over
Kilmarnock and also scored three days later against
Partick Thistle. Hearts were relegated at the end of the season, but immediately won promotion by winning the
2014–15 Scottish Championship. In their first season back in the top flight, Hearts finished third in the
2015–16 Scottish Premiership and qualified for European competition. During the summer of 2016, Patterson was subject to interest from several
EFL Championship sides, with Hearts rejecting two bids from
Wigan Athletic. Despite the interest, he stayed at the club, managing to score 9 goals in 20 appearances, before suffering a serious knee injury on 27 December, which ruled him out for six to nine months. Despite missing the last few months of the season, Paterson managed to pick up the club's Young Player of the Year Award. The knee injury suffered at Hearts kept him out of the first two months of the season, making his playing return for the
Under-23 side in a 4–0 win over
Burnley, on 18 September. On 21 October, Paterson returned to the first team, making his debut in a 1–0 win over
Middlesbrough, before scoring his first goal for the club, the winner at
Barnsley, a month later. Cardiff manager,
Neil Warnock moved Paterson into a central midfield position in the new year, later stating the reasoning behind the move was because he couldn't defend. Following his move to the new position, Paterson scored a brace against
Sunderland on 13 January and found the back of the net three times in March. He continued his good form throughout the rest of the season, scoring 10 goals, ending as the club's top goal scorer in the league, as they were promoted to the
Premier League. Paterson was also voted Young Player of the Season by the Cardiff fans. Paterson played his first Premier League game against
Bournemouth on the opening day of the season. As Cardiff struggled for goals, Paterson was moved into a central forward role, where he scored his first Premier League goal in a 4–2 win over
Fulham.
Sheffield Wednesday On 30 September 2020, he joined
EFL Championship club
Sheffield Wednesday for an undisclosed fee. He made his club debut the following weekend against
Queens Park Rangers and scored his first goal for the club against
Brentford on 21 October 2020. He would win the clubs player of the month for January after scoring goals against
Derby County and
Exeter City as well as the final game in December against
Middlesbrough. On the opening day of the 2021–22 season against
Charlton Athletic, he would suffer a nasty head injury following a collision after Paterson cleared a certain goal. Following promotion back to the
EFL Championship Paterson was offered a new contract to stay at the club which was signed on the 8 June 2023. On 9 February, manager
Danny Röhl, confirmed that Paterson was facing an extended spell on the sidelines after undergoing surgery on a recent knee injury. On 17 May 2024, Wednesday exercised their option to keep Paterson another year. He won the clubs player of the month for February 2025, after scoring goals against
West Bromwich Albion and
Sunderland. He was offered a new contract following the end of the
2024–25 season.
Milton Keynes Dons On 28 July 2025, Paterson signed for
League Two club
Milton Keynes Dons. He made his debut for the club on 2 August 2025, the opening day of the
2025–26 season, in a 0–0 home draw with
Oldham Athletic. He scored his first goal for the club in the following game, against
Barrow, scoring the second goal in a 2–0 away win. On 24 January 2026, Paterson scored his first career
hat-trick in a 5–1 home win over
Shrewsbury Town. Despite missing six weeks of the season due to injury, he was later nominated for the
EFL Player of the Season award for League Two, having scored 14 goals and providing 8 assists up until 6 April 2026. On 19 April 2026, Paterson was named in the
EFL League Two Team of the Season for the
2025–26 campaign, alongside teammates
Liam Kelly and
Jack Sanders. ==International career==