In the 1980s, Pazienza built a reputation along the East Coast, defeating such opponents as Melvin Paul (KO 2), Joe Frazier Jr. (TKO 7), Harry Arroyo (UD 10), Nelson Bolanos (TKO 6), and Roberto Elizondo (KO in 10). His first world title fight came on June 7, 1987, in Providence, Rhode Island, where he outpointed Greg Haugen over 15 rounds to become the IBF world lightweight champion.