Early years Patterson began his coaching career in 1982 at
Kansas State University as an assistant to head coach
Jim Dickey. After subsequently serving a number of years as an assistant coach at a number of different schools, Patterson was hired by
Dennis Franchione as the
defensive coordinator at the
University of New Mexico in 1996. He had previously served as a
linebackers coach at Tennessee Tech (1983–1984) where Franchione was the
offensive coordinator and in the same capacity on Franchione's
Pittsburg State University staff in 1988, as well as playing on the
1980 Kansas State Wildcats football team when Franchione was an assistant on the coaching staff. He followed Franchione to
Texas Christian University (TCU) in 1998, serving as the defensive coordinator there, as well. Patterson was a 2000 finalist for the
Broyles Award, given annually to the nation's top college football assistant coach. He was named head coach at TCU prior to the
Mobile Alabama Bowl in December 2000 after Franchione left to become the head coach at the
University of Alabama. Patterson remains friends with
New Mexico State head coach
Jerry Kill from their time as coaches on Franchione's Pittsburg State staff. Kill served as the
best man during Patterson's wedding to wife Kelsey in 2004. His teams won 10 games or more in a season eleven times. Only three times have they failed to reach a bowl, in 2004, 2013, and 2019. Under Patterson, the Horned Frogs earned a spot in the year-end top 25 ten times, counting his partial season as head coach in 2000. In 2005, Patterson led the Frogs to the
Mountain West Conference championship in their first season as a member. Over the course of the 2005 and 2006 seasons, the Frogs won four consecutive games against
Big 12 Conference opponents, with three of the victories coming on the road. He tandem jumped with the Army Golden Knights prior to the 2005 TCU vs. Army football game, crossing skydiving off his bucket list. Patterson was named the 2005 Mountain West Conference Coach of the Year. Patterson led the
2009 Horned Frogs to a perfect 12–0 regular season record, a Mountain West Conference championship, a No. 4 final
BCS ranking, and an invitation to the
2010 Fiesta Bowl—their first major bowl appearance in 51 years. They ultimately lost 17–10 to undefeated No. 6
Boise State. The 2009 Horned Frogs became the second "
BCS Buster" from the Mountain West Conference (and the fourth, overall). For much of the season, they were a contender for the
2010 BCS National Championship Game. However, any chance of the Horned Frogs playing for the national championship ended on the final day of the season, when
Cincinnati defeated
Pitt. This assured that two teams from
Automatic Qualifying conferences would finish the regular season undefeated (whoever won the
2009 SEC Championship Game would have also finished undefeated). Patterson was named the 2009
AP Coach of the Year, becoming the first head coach of a BCS non-AQ conference team to win the award. He won a total of seven national "Coach of the Year" awards in 2009 The Frogs went 6–7 (4–5) in 2016 losing 31–23 to Georgia in the Liberty Bowl. In 2017, TCU opened with a 63–0 victory Jackson State. They defeated Arkansas 28–7 in Week 2. In Week 3, the No. 20 Frogs beat SMU in the Iron Skillet Rivalry 56–36. In week 4, the No. 16 Frogs upset No. 6 Oklahoma State 44–31 behind a 31 carry 160 yard 3 touchdown performance from halfback
Darius Anderson. Next, the No. 9 Frogs won 31–24 over No. 23 West Virginia in a game in which quarterback
Kenny Hill had a passing, rushing, and receiving touchdown. No. 6 TCU then won 26–6 over Kansas State and moved up to No. 4 with a 6–0 start. They shutout Kansas 43–0 to move to 7–0 and lead the Big 12. However, in Week 8 they lost 14–7 to No. 25 Iowa State dropping to No. 8. They beat Texas the next week 24–7 moving up to No. 6, but they lost 38–20 to No. 5 Oklahoma. TCU bounced back by beating Texas Tech 27–3 in which Kenny Hill didn't play. In Week 13, the No. 12 Frogs beat Baylor 45–22 to finish 10–2. They made the Big 12 Title Game as No. 11 but lost 41–17 to No. 3 Oklahoma. They dropped to No. 13 and were selected to the Alamo Bowl against No. 15 Stanford. TCU beat Stanford 39–37 to win the Alamo Bowl. Patterson began the 2021 season 3–5 and resigned on October 31, 2021, after being told he would not return for 2022. At the time of his departure, he was the second longest tenured coach in the FBS, only behind Iowa's
Kirk Ferentz.
After TCU Patterson served as an off-field analyst at the
University of Texas for the 2022 season, working with head coach
Steve Sarkisian. After taking the 2023 season off, he spent six months as a consultant at Baylor, departing before the start of the 2024 season. Patterson was enshrined into the university’s Athletics Hall of Fame on September 18, 2025 and honored at halftime against rival
SMU on September 20, 2025.
USC On January 21, 2026, Patterson was named defensive coordinator at
USC. ==Charitable work==