A football coach with experiences as youth coach of Roma and Internazionale, he was appointed in charge of first team duties on 26 March 2012 to replace Claudio Ranieri. He is also a 2010 law graduate.
He graduated in law at La Sapienza University of Rome, the largest Italian university. After retiring as a footballer, Stramaccioni went on to become a football coach for a number of amateur youth teams. At age 25, he won a provincial title with Rome-based youth team Az Sport, then being hired by Romulea where he worked until 2005. Stramaccioni obtained the licence for youth coaches in 2003.
In 2005, Stramaccioni joined the youth coaching staff at Roma, winning two national titles: Giovanissimi Nazionali in 2007 and Allievi Nazionali in 2010. On 9 May 2009, Stramaccioni obtained a UEFA A coaching licence (Italy second category licence), made him eligible to work as a head coach of Lega Pro teams or as a vice-coach of Serie A and Serie B clubs. Stramaccioni, however, did not have a UEFA Pro Licence (Italy first category licence), he could only work as a care-taker in the first and second division of Italy. On that day, Roberto Samaden, Inter youth academy director since 2006, also obtained the same licence. Samaden met Stramaccioni in the course and gave Stramaccioni a job in Inter two years later.
After the departure of Fulvio Pea, who left Internazionale Primavera in summer 2011 to become the new Sassuolo head coach, Samaden called Stramaccioni to offer him the vacant position at the club, which he accepted (Roma was unable to offer the same position to Stramaccioni as Alberto De Rossi was the coach of that team and 2011 champion). Inter Primavera was the first in the Group B of its own league as of round 21 (22), the last round Stramaccioni was in charge, ahead Milan with one more point (both 21 games) and Varese with two points (and Varese had one more game, 22). Inter round 22 match was rescheduled and Milan also had a match (round 17) rescheduled. Primavera had a record of 13 wins, four draws, four losses, 43 goals scored, and 19 goals scored against. Stramaccioni also led Inter Primavera to the final of the 2011–12 NextGen series, after defeating Sporting Clube de Portugal in the Estádio Dr. Magalhães Pessoa, Leiria, and Olympique de Marseille on 21 March in Griffin Park, London. The final was played on 25 March in Matchroom Stadium. The match finished in a 1–1 draw and Inter beat AFC Ajax 5–3 in the resulting penalty shoot-out. On the same day as Inter's NextGen victory, the first team lost 2–0 to Juventus.
On 26 March 2012, Inter manager Claudio Ranieri was sacked and Stramaccioni was promoted to manager of the first team as caretaker, with Giuseppe Baresi returning to act as assistant coach. He led Inter to sixth place and a success in the Derby della Madonnina against Milan that cost Inter's crosstown rivals the Serie A title; his results led club owner Massimo Moratti to confirm him as head coach for the 2012–13 season, as well. The FIGC allowed Stramaccioni to sign the contract without a UEFA Pro Licence as he was admitted to 2012–13 coaching course in order to obtain the licence in June 2013. On 3 November 2012, Stramaccioni guided Inter to a 3–1 away victory over the previous season's champions, Juventus, claiming "[The] result will send a signal, as we came here to the Juventus Stadium against a team unbeaten in 49 rounds and attacked them with a trident". After 14 months in charge of Inter and a difficult 2012-2013 Serie A campaign which saw them finish in 9th place and thus fail to qualify for Europe for the first time in 15 seasons, the club announced on 24 May 2013 that Stramaccioni had been sacked and replaced by Walter Mazzarri.