He was born in Boston, Massachusetts in 1949 to a hardworking Italian family. His father was of Italian descent and was a professional trombonist with the Les Brown Orchestra. He was enrolled into Catholic school and became an altar boy, where his talent for acting was discovered.
He was originally planning on being a lawyer before he discovered he had a talent for acting. He is left-handed and enjoys to play golf in his spare time. Pilato plays the guitar, accordion, and taught himself the trombone. He does not own a computer. He is close friends with Dawn of the Dead stars David Emge and Ken Foree. He often attends horror conventions and loves to meet his fans, often posing for pictures and signing autographs.
In 1984, six years after the release of Dawn of the Dead, George A. Romero, the man who invented the modern zombie, was planning a new zombie film called Day of the Dead, which would involve military scientists and soldiers hiding in an underground bunker trying to find out a way to stop the epidemic while the world above was slowly being overrun by the living dead. Ironically, he had appeared as a cameo in Dawn of the Dead in 1978, five years prior, as a police officer, which had been his first feature film role. Pilato was selected to play United States Army Captain Rhodes. He is perhaps best known for his performance, and the film, along with its predecessors, has become a classic.