He joined a group called The Tyme in 1965 which played at local youth clubs.
Thompson's next group was a local band called The Urge which he joined when 17 years old. Tiredness from performing with them seven nights a week in local clubs and pubs led him to fall asleep on his job as an apprentice metalworker, which resulted in his dismissal.
In 1980, Thompson took leave from Roxy Music due to a thumb injury. Later that year he left the band due to musical differences between himself and Bryan Ferry; and Thompson played with musicians like Gary Moore, Jonathon Perkins and Concrete Blonde.
Fans nicknamed him "The Great Paul Thompson", because of his remarkable drumming skills and power.
In 2001, he reunited with his fellow Roxy Music band members for a tour (excluding Eno, who refrained from participating). He also toured with Ferry, supporting his Frantic album in 2003. The band, again with Thompson on the drum stool, performed on 11 June 2005 at the Isle of Wight Festival 2005.
Thompson's latest project is his new band The Metaphors.