He began his career in golf course design with his family's firm in suburban Philadelphia, which he left in the 1960s. He established his own company in Jupiter, Florida in 1972. He is the nephew of George Fazio, who often credited Tom with jump-starting his career in golf course architecture.
Fazio has more courses ranked among the top 100 in the U.S. than any other active golf architect. His individual honors include Best Modern Day Golf Course Architect, which he received from Golf Digest Magazine three times. In 1995, Fazio became only the second course architect to receive the highest recognition awarded by the Golf Course Superintendents Association of America - The Old Tom Morris Award.