Patsy is the accountant for Tony Soprano's crew, and is often seen calculating the group's finances in the Bada-Bing or Satriale's offices. He also acts as a soldier, performing various enforcement tasks for the family. In addition to that, he also procures fine Italian suits for his friends and associates. Patsy is somewhat of a "dark horse" character; he has very little back-story compared to the other members of the crew, and relatively few lines, but visually, he is frequently present on screen. He shares this characteristic with Carlo Gervasi, another high-up member of Tony's crew who is frequently seen but about whom little is known to the audience. Patsy has the distinction of being the only mobster in Tony's group with eyeglasses, giving him a scholarly appearance. He is also never seen smoking cigarettes or cigars, and appears to be in better physical shape for his age than most of the crew — in the episode "Christopher", he single-handedly climbs up a metal utility pole to take down an effigy of Christopher Columbus during a Native American protest. He has an organization, the North Ward Emergency Merchants Protective Cooperative, that is used to extort store-owners along with Burt Gervasi.
Patsy had an identical twin brother, Phillip "Philly Spoons" Parisi (also played by Dan Grimaldi) who was fluent in English and Italian, and hailed from Bloomfield, New Jersey. Patsy was born eleven minutes before his brother Phillip, whom he described as a "sweet" and "gentle man" who was never "heavy" (violent) with anyone. Philly had a hit taken out on him by Tony and was killed by Soprano soldier Gigi Cestone. At the time of his death, Philly was acting capo of Junior Soprano's crew and Patsy was a member. Patsy never had concrete evidence about his brother's murder, but it occurred soon after a brief and bloody war between Junior and Tony, and Philly was known to be talking about Tony's actions. It was this killing that prompted Tony to move Patsy to keep an eye on him. Patsy took the killing very hard, which brought on a problem with alcoholism and considering killing Tony — in September 2000 a drunken Patsy was observed by Federal Bureau of Investigation (FBI) agents outside the Soprano family home leveling a gun at Tony through his window on his birthday. He reconsidered though, and only urinated in the Sopranos' pool. Patsy also openly vented his feelings of loss to the Soprano crew in front of the men responsible for his brother's death, Gigi and Tony, at a dinner in the back of Satriale's. However, he eventually put his grief behind him.
Patsy still has questionable loyalties. When Patsy's then capo Paulie Gualtieri was in prison in September 2002, Tony promoted Christopher Moltisanti to acting captain over Patsy (who had seniority). Patsy didn't take this well, eventually getting into a fight with Christopher. Once Paulie was released and moved up to Underboss, Christopher took over as capo of the crew permanently; Patsy eventually seemed comfortable working with him.
In the penultimate episode "The Blue Comet", Patsy is nearly killed by two men sent to murder Silvio Dante. Patsy manages to hold them off, but Silvio is badly wounded and put into a coma, and Patsy runs into the woods fleeing for his life. He survives and later celebrates his son's engagement to Meadow Soprano with Tony and his family, seeing a great opportunity to get closer to Tony.
As a soldier
Throughout his time with the crew, Patsy has never been seen to commit murder. However, he showed a certain skill for intimidation when warning off Tony's ex-comàre, Gloria Trillo.
Patsy and Benny Fazio work with Angie Bonpensiero, handling her money on the street and providing stolen car parts for her auto body repair shop. Patsy helped Paulie intimidate Jason Barone when he was considering selling Barone sanitation following his father's death. He was present when Tony won the respect of the crew by beating up Perry Annunziata at Satriale's. With the revelation that Vito Spatafore was homosexual, Patsy was one of the few crew members not to bay for blood — he laughed at Christopher's jokes and his statement "I could care less" earned derision from Paulie Gualtieri.
Despite not being considered one of Tony's "inner circle," Patsy is viewed as a reliable and trustworthy soldier by Tony. When Christopher Moltisanti is forced to go into rehabilitation for his heroin addiction, Patsy is entrusted with watching him to ensure he does not try to escape. It was implied Tony authorized Patsy to eliminate Christopher should he have escaped, however in Whitecaps, Patsy reports to Tony that Christopher graduated drug rehab, making murder unnecessary.
Patsy makes collections in the North Ward neighborhood. He has been having problems in the area with franchised businesses that refuse to pay him, and the selling of Caputo's poultry (a longtime local store) by Tony annoyed Patsy. Patsy was accompanied on his rounds by newly made man Burt Gervasi. Patsy helped Paulie organize the Feast of St. Elzear in co-ordination with the local church. Patsy genuflected upon entering the church for a meeting with the priest—he takes his Catholicism seriously despite his lifestyle.
Pasquale Parisi is a second generation Italian-American; his family hailed from Ariano di Puglia, since renamed to Ariano Irpino, in Campania, Italy.
Patsy is married to Donna Parisi but has been shown with other women while the crew are out with their girlfriends. There is some suggestion that at one point in time Pasquale and Ralph Cifaretto shared a mistress. He has two sons— Patrick Parisi in the legal field and Jason Parisi who attends college and is involved with sports betting. In the episode Mr. Ruggerio's Neighborhood, Tony mentions a daughter of Patsy's, but she is never referenced again. In Season Six, Patsy seems pleased that Patrick is dating Meadow Soprano and tells Tony that "wedding bells are in the air" and that they are not too young to be grandfathers. He also previously expressed his pride in Jason's computer and gambling skills. It is also interesting to note that while his eldest son Patrick appears to be an upstanding citizen, pursuing a career in law and dating Meadow Soprano, a like-minded individual, his younger son Jason appears to be a complete sociopath. He is sadistically violent and as he is already involved in sports betting at a young age looks like he is an ideal recruit for the next generation of the DiMeo crime family.
As the series comes to an end, some viewers think it is implied that Patsy will be much closer to Tony and will be promoted because of the vacant spots in the mob leadership (the death of Bobby, Silvio's coma, and the betrayal of Carlo Gervasi) as well as the engagement of Meadow and Patrick. However, some point to the friendship of Patsy with Carlo, the friendship of their sons (both of who have been arrested recently for drug dealing), the overall awkward interaction of Patsy and Tony in Patsy's final scene, and Patsy's potential bitterness over his brother's murder as reasons to believe that Patsy either played a role in the potential hit on Tony as the series concludes or he himself was an informant. However, said awkward interaction could be a result of Patsy's shame due to having fled the scene of Silvio's shooting.
- Patsy Parisi is the show's only supporting character to appear in more than half the episodes.