He has appeared in Sons of the Prophet by playwright Stephen Karam, playing the role of Charlie. For his work as Charlie, he received a Theatre World Award for Best Debut Performance in an Off-Broadway play. Starting in December 2012, Perfetti played Bomber in the revival of Picnic by William Inge. Perfetti appeared as Ariel in The Tempest at the Delacorte Theater in the summer of 2015.
Perfetti is also known for starring in Submissions Only (2010), Next Caller (2012), the NBC series Crossbones (2014) as series regular Tim Fletch, and as the character Brady in the second season of the HBO show Looking (2015), and its subsequent series finale television film, Looking: The Movie (2016).