He is an American bass guitarist specializing in the heavy metal music genre.

He was a member of 1980s classic metal rock bands Dokken and Dio. He currently has his own progressive metal group called War and Peace, and works with his ex-Dokken bandmate, guitarist George Lynch, in a two-member group called Lynch/Pilson, and is in Foreigner.

He also played in the band Wild Horses (the American band, not the British band).

Although he is a renowned primarily for his work as a bass guitarist, he is multi-instrumental.

He played a member of the band Steel Dragon in the 2001 film Rock Star as well as playing on the film's soundtrack.