Gemignani began his career in 1971 as a replacement musical director for Stephen Sondheim's Follies, eventually leading the cast on the subsequent tour. Since then, he has been the musical director for over 38 Broadway and West End musicals, including the following Tony Award-winning productions: A Little Night Music (1973), Sweeney Todd (1979), Evita (1979), Jerome Robbins' Broadway (1989), Crazy for You (1992), Passion (1994), Kiss Me, Kate (1999), Into the Woods (2002), and Assassins (2004). Other well-known Broadway productions have included Candide (1974), Grind (1975), Pacific Overtures (1976), Side By Side By Sondheim (1977), On the Twentieth Century (1978), Merrily We Roll Along (1981), A Doll's Life (1982), Zorba (1983), The Rink (1984), Pulitzer Prize winner Sunday in the Park with George (1984), Big: the musical (1996), High Society (1998), The Frogs (2004), and 110 in the Shade (2007).
Gemignani has been the Musical Director for three separate productions of Sweeney Todd, including the original Broadway and London productions (1979 - 1982), the Royal Opera House production in London (2003-2004) and the 2007 film version with Johnny Depp (music conductor and supervisor). He has been involved in most of the other presentations of Sweeney in the last twenty years.
Gemignani has recorded numerous cast albums and albums featuring musical theatre and opera singers with American Theatre Orchestra and other orchestras. He has been a guest conductor with the Boston Symphony Orchestra, the San Francisco Symphony, the Buffalo Philharmonic, the Philadelphia Orchestra, the Baltimore Symphony, the Royal Philharmonic Orchestra, the London Symphony Orchestra, New York City Opera, Lyric Opera of Chicago, Royal Opera, and New York City Ballet. He has conducted such films as Kramer vs. Kramer (1979), Reds (1981), and Sweeney Todd (2007), as well as many television specials, including several installments of Great Performances.
He was the recipient of a 1989 Drama Desk Special Award and a 2001 Tony Award for Special Lifetime Achievement. In 2006, he received an Emmy Award for "best musical direction" for the PBS/Great Performances presentation of Rodgers and Hammerstein's South Pacific in concert from Carnegie Hall. Gemignani was honored in an all-star concert, "Another Op'nin, Another Show: A Musical Tribute To Paul Gemignani" on March 30, 2008.
- Hutchins, Michael H. "Sondheim People". The Stephen Sondheim Reference Guide. Retrieved 2018-01-03.
- "Photo Coverage: Starry Tribute to Paul Gemignani". broadwayworld.com. Retrieved 2008-06-12.
- Each of these won either Tony Award for Best Musical or Tony Award for Best Revival)
- "Paul Gemignani". Internet Broadway Database. Retrieved 2008-06-12.
- "Music and Musicians: Paul Gemignani". Hollywood Bowl. Retrieved 2018-01-03.
- "Paul Gemignani". IMDb. Retrieved 2008-06-12.
- Tommasini, Anthony (May 9, 2008). "That Congenial Spot Revisited, With a World-Class Orchestra Playing Along". The New York Times (Music Review).
- Gans, Andrew; Thomas, Peter (September 25, 2010). "EXCLUSIVE: Linda Lavin, James Lapine, Brian Dennehy Among Theater Hall of Fame Inductees". Playbill. Retrieved 2018-01-03.
- Paul Gemignani at the Internet Broadway Database
- Paul Gemignani on IMDb
- Paul Gemignani profile at The Stephen Sondheim Reference Guide
- Paul Gemignani credits at BroadwayWorld.com
- Interview- Paul Gemignani: “Stephen Sondheim is a great musician, a wonderful collaborator and a friend” - todoMUSICALES, February 2010