Pearson started his career with Hull City (129 appearances/44 goals). During his time at Hull City his efforts, on one occasion, earned him the memorable headline "Onion Stu Lands City In A Pickle": this headline came about after Pearson was sent off for calling the linesman "a bloody onion". He later joined Manchester United (139/55) in 1974 for £200,000. Pearson was bought by Manchester United after they were relegated to the 2nd Division and was instrumental in getting the club promoted back to the 1st Division the very next season by scoring 17 goals. Every time he scored a goal he would celebrate with an upraised right fist. Pearson went on to help Manchester United win the 1977 FA Cup against Liverpool, scoring the first of Manchester United's goals in their 2-1 win. He was sidelined for most of the 1978-79 season due to a knee injury but made a full recovery before leaving Manchester United for West Ham United (34/6) in 1980. He helped the Hammers win the 1980 FA Cup. Pearson retired from league football in 1982 due to a knee injury, but continued to play at a lower level, in South Africa and the NASL. In his 15 caps for England, Stuart scored 5 goals. His nickname was "Pancho" Pearson, named after an earlier Manchester United player called Mark Pearson.
After retiring as a player, Pearson moved into coaching, serving as coach of Stockport County in 1985-86 and manager of Northwich Victoria during the first half of 1986-87. He became assistant manager / coach at West Bromwich Albion in 1988 and acted as caretaker manager for six games in 1991 following Brian Talbot's departure. Pearson left Albion in 1992 and was assistant manager at Bradford City from 1992 to 1994. In recent years he has been a pundit for MUTV. Pearson is an Old Trafford regular who despite living in Spain travels back to Manchester for every home game.