Pančev was the highest scorer in top-division European football in the 1990-1991 season with 34 goals, and should have won the European Golden Boot award. However, France Football decide to make the competition unofficial for the season because of suspect scoring sprees in Cyprus. Pančev did not get the prize at the time, but received it fifteen years later on 3 August 2006 in Skopje. The Golden Boot was presented at a special gala by Michel Platini, Dragan Stojković and Dragan Džajić.
His playing career started in 1982 at Vardar Skopje, then in 1988 he moved to Red Star Belgrade, with whom he played four years, scoring an incredible 94 goals from 91 league appearances, and winning the European Cup and the Intercontinental Cup in 1991.
In the early 1990s, he was widely recognized as one of the best strikers in the world. All Red Star fans remember Pančev as being the player that scored the winning penalty in the 1991 European Cup Final, bringing Red Star the most prestigious trophy in European football for the first time in its 50-year existence.
Pančev played in Italia 90 for Yugoslavia and scored two goals in the 4-1 win over the UAE in the first round. It proved to be the only international tournament he played in, due to the ban on Yugoslavia participating in Euro 92 because of the war in Bosnia at the time, although by the end of the European qualifying group stages, he was the top marksman on the continent with 8 goals for the group qual stage.
In 1992 Pančev was signed by prominent Italian team Inter Milan. He was not, however, able to show his scoring abilities. He played just 12 matches for Inter Milan, scoring 2 goals (1 in copa italia fixture). He was then loaned in January 1994 to German team VfB Leipzig (10 matches and 2 goals).
In 1994, he made up part of the inaugural Macedonia's football team as the star player. Back to Inter Milan for the season 1994-1995, he played 7 matches and scored 2 goals, before leaving the nerazzurri in order to join Fortuna Dusseldorf the next season (14 matches, 2 goals).
In November 2003, to celebrate UEFA's Jubilee, he was selected as the Golden Player of Macedonia by the Football Federation of the Republic of Macedonia as their most outstanding player of the past 50 years.