Paterson was born in Harlem on April 27, 1926, the son of Leonard James and Evangeline Alicia (Rondon) Paterson. His father was born on the island of Carriacou in the Grenadines and arrived in the United States aboard the S.S. Vestris on May 16, 1917 in New York City. His mother was born in Kingston, Jamaica and arrived in the United States on September 9, 1919 aboard the S.S. Vestnorge in Philadelphia with a final distination of New York City. A stenographer by profession, the former Miss Rondon once served as a secretary for Marcus Garvey. In 1942, at the age of 16, Paterson graduated from De Witt Clinton High School in the Bronx. His studies continued at St. John's University where his college studies were interrupted by a two year stint in the army during World War Two. He graduated in 1948 with a B.S. in biology. This was followed by admission to St. John's Law School, where he received the degree of Juris Doctor in 1951.
Paterson became involved in Democratic politics in Harlem in the 1950s and 1960s. Along with former New York Mayor David Dinkins, former Manhattan Borough President Percy Sutton, and Congressman Charles Rangel, Paterson is a leader of the "Harlem Clubhouse," which has dominated Harlem politics since the 1960s.
In 1965 Paterson was elected to the New York State Senate representing the Upper West Side of New York City and Harlem. He gave up his Senate seat in 1970 to run for lieutenant governor, as the running mate of former U.S. Supreme Court Justice Arthur Goldberg. The Goldberg/Paterson ticket lost to the Republican ticket of incumbent Gov. Nelson Rockefeller and Lt. Gov. Malcolm Wilson.
In 1978, Paterson was appointed as a Deputy Mayor of New York City by then Mayor Ed Koch. He stepped down as deputy mayor in 1979 to become New York Secretary of State, and served until the end of the Hugh Carey administration in 1983. He was the first black New York Secretary of State.
Currently, Paterson is a Member of the law firm of Meyer, Suozzi, English & Klein, P.C., where he is co-chair of the firm's Labor practice.
Paterson is the father of New York Governor David Paterson, who was elected lieutenant governor on November 7, 2006 on a ticket with Gov. Eliot Spitzer. David Paterson became governor on March 17, 2008, after Spitzer resigned. When his son became lieutenant governor, Basil Paterson said that fact may actually "get in the way" of his livelihood as a negotiator and lawyer for the hospital workers and Teamsters unions.