In 1984, Bearer joined World Class Championship Wrestling in Texas as Percy Pringle III. During this time, he served as manager for numerous wrestlers; he notably managed Rick Rude and "Stunning" Steve Austin in their early careers. He was also associated with the careers of Lex Luger, Eric Embry, and The Ultimate Warrior.
He joined the World Wrestling Federation (WWF) in December 1990, as Paul Bearer, a mortician manager. In his portrayal of a very histrionic, ghostly manager, he was almost always seen bearing an urn (which led to several storylines involving wrestlers stealing his urn), and whose catch phrase was "Ohhh yyes!"
Bearer made his first appearance in February 1991, as a heel, when Brother Love, who originally managed The Undertaker, passed him on to be managed by Paul Bearer. Bearer took on a spookier, ghastlier character. Bearer also hosted the WWF talk show segment entitled The Funeral Parlor, which included memorable segments such as the Ultimate Warrior being locked inside a casket, among others. In 1992, The Undertaker and Bearer turned face, when Undertaker stopped former ally Jake "The Snake" Roberts from ambushing Randy Savage and Miss Elizabeth with a chair backstage.
Eventually Bearer turned heel again by betraying his long-time protege at SummerSlam 1996 to align himself with The Undertaker's arch-enemy, Mankind. During this time, he hired The Executioner and Vader, in order to take out Undertaker. In April 1997 at In Your House 14: Revenge of the 'Taker, The Undertaker set Bearer's face ablaze using a fireball. As a result, Bearer's head was bandaged for a time before changing his looks, shedding the makeup of ghostly pallor and jet-black color to his natural strawberry blond hair and less make-up. No longer using his ghostly appearance and mannerisms, he became loudmouthed and shrill. Around mid-1997, Paul Bearer coerced Undertaker (WWF Champion at the time) into being his protégé again with the ultimatum of revealing a deep, dark secret from the past. During this time, Bearer made references to "the fires of hell." Feeling he had no choice, The Undertaker accepted after several weeks of resistance. While "managing" Undertaker this time around, Bearer engaged in tyrannical behaviors towards him, harassing him constantly. Eventually, Undertaker lost his patience and refused to allow Bearer to continue being his manager, leading Bearer to reveal the secret.
The secret suggested that Bearer had a traumatic past with The Undertaker which long preceded Brother Love's joining the two in January 1991. The secret, which involved the Undertaker's family, was: The Undertaker's mother had an affair with Paul Bearer who was working under the Undertaker's parents in the family funeral home, and as a result, gave birth to a younger half-brother of The Undertaker, named Kane. Throughout The Undertaker's childhood and teen years, he lived in a funeral home with his parents and half-brother. According to Paul Bearer, The Undertaker accidentally killed his parents by setting the funeral home ablaze and caused his half-brother's face to be bruised, burned, and scarred. At the time throughout mid to late 1997, The Undertaker denied all this, claiming it was his younger half-brother's fault. Bearer accused The Undertaker of being an "arsonist", "murderer", and "liar."
Because of the fire incident, The Undertaker thought his younger half-brother and Bearer's illegitimate son had been dead for years. But Bearer introduced Kane in October 1997 at Badd Blood: In Your House, where Kane cost The Undertaker a Hell in a Cell match against Shawn Michaels. This led to a bitter rivalry between The Undertaker and Kane and Bearer. Kane was not revealed as Bearer's son until April 27, 1998, on Monday Night Raw, a day after the first Inferno Match, at Unforgiven, where Kane was set on fire. The Undertaker was shown to have also been unaware of this at that time, and helped to build the feud up further, as Undertaker initially refused to believe the story until an in-story DNA test proved it to be true. The feud lasted into summer of 1998, when Kane seemingly abandoned Bearer to side with The Undertaker, beginning a face turn.
Bearer and The Undertaker became a heel team again toward the end of 1998 when Bearer betrayed his own son, Kane, in favor of managing The Undertaker once again. Once becoming a heel with Bearer, The Undertaker shamelessly admitted to setting the funeral home ablaze for which he had initially claimed was an accident or blamed Kane. Shortly thereafter, Bearer (returning to his signature look) and The Undertaker formed the Ministry of Darkness. Both he and The Undertaker took a hiatus from the WWF unceremoniously in September 1999 as a result of The Undertaker suffering an injury.
In early 2000, Bearer, who turned face once more briefly, returned to WWF TV as Kane's manager, but he retired from on-screen performing shortly after WrestleMania 2000. Later that year, he went backstage to serve as a WWF road agent, stage manager, and talent scout. His contract with WWE ended in 2002.
He reappeared in March 2004 at WrestleMania XX, alongside Undertaker in a match against Kane. Paul Bearer also appeared on television as The Undertaker's manager.
In the spring of 2004, Paul Bearer was kidnapped by The Dudley Boyz under the direction of Paul Heyman. This was set up in order to temporarily write Bearer out of WWE storylines because he had to undergo emergency gallbladder surgery. For the June 27, 2004 pay-per-view The Great American Bash, a match pitting The Undertaker against both of The Dudley Boyz was booked. Paul Bearer was encased in a glass "crypt" at ringside, covered up to his chest in cement. Heyman demanded The Undertaker throw the match or Bearer would be suffocated in cement. The Undertaker won the match but proceeded afterwards to pull the lever that sent cement into the crypt, completely burying Paul Bearer, suffocating him. On the following week's SmackDown!, Bearer was acknowledged to be alive, although gravely injured, for storyline purposes.
On June 10, 2005, Bearer announced that he had signed a new deal with WWE. In late January 2007, at a SmackDown/ECW house show in Mobile, Alabama, Bearer joined The Brothers of Destruction at ringside, carrying the original urn.
On the September 24, 2010, episode of SmackDown, Bearer made his first on-screen appearance in six years after being brought out in a casket. He helped The Undertaker, who was feuding with Kane over the World Heavyweight Championship, by restoring Undertaker's powers with the urn. Bearer officially became Undertaker's manager again by accompanying him to the ring for his match against Kane for the title at the Hell in a Cell pay-per-view. During the match, Bearer once again turned on Undertaker, after shining a light in his eyes when he was about to Tombstone Kane. He then let Kane hit Undertaker with the urn to help him win. On the October 15 episode of SmackDown, Bearer challenged Undertaker to face Kane in a Buried Alive Match for the World Heavyweight Championship at Bragging Rights, to which Undertaker accepted by attacking Kane. At Bragging Rights, Kane once again defeated Undertaker after interference by Bearer, who was almost thrown in the grave by Undertaker, and The Nexus, who helped Bearer and Kane bury Undertaker.
Kane then entered a feud with Edge, after he was named the new challenger to Kane's World Heavyweight Championship at Survivor Series. On the November 12 episode of SmackDown, Kane cost Edge his match against Nexus member David Otunga. After the match, Edge kidnapped Bearer by strapping him in a wheelchair. Later that night, Edge used Bearer to cost Kane his match against Big Show. The following week, Edge tormented Bearer throughout the night by throwing a dodgeball at him and force feeding and throwing pizza all over him. Edge then used Bearer to call for Kane in the parking lot, but Kane wasn't able to get Bearer in time as Edge attacked him and drove off with Bearer. At Survivor Series, Edge brought an empty wheelchair causing Kane to go mad frantically trying to interrogate him on where Bearer was held. Even though the match ended in a draw, Kane was unable to find Bearer as Edge wheeled his enemy into a barricade. On the November 26 episode of SmackDown, Kane demanded that Edge to let Bearer go, but Edge refused. Kane attempted to track down Bearer, but was unable to find him. Kane offered a second title shot to Edge, which he accepted, but continued to keep Bearer with him. At the end of the night, Edge lured Kane to the parking lot, where Edge drove over a dummy version of Paul Bearer, with the actual Paul Bearer in the backseat of the car. On the December 3 episode of SmackDown, Edge continued his mind games with Kane by pushing a dummy version of Paul Bearer down some stairs. Then, after Edge defeated Kane in a non-title match, he brought out a Paul Bearer lookalike. Kane then went to search for Bearer again, but Edge drove away in a truck with Bearer tied up on the back. The following week, Kane begged Edge to return Bearer, but Edge once again refused. Kane then refused to participate in the main event that night and once again searched for Bearer. After seeing what he thought was a dummy version of Paul Bearer on top of two ladders, Kane pushed them over. Afterward, Kane saw that he pushed the actual Paul Bearer off the ladders onto the concrete floor, thus, injuring him and writing him out of the storyline.
In April 2012, Bearer returned for a brief stint as a part of Kane's ongoing feud with Randy Orton. He was kidnapped by Orton and then stuck in a storage freezer while strapped to a wheelchair. Kane later came for Bearer, only to roll him back into the freezer and saying, "I'm saving you... from me".
Bearer passed away on March 5, 2013.
Following his death, Bearer became a driving point in WWE storylines. The March 11 episode of Raw was held as a tribute to Bearer, The Undertaker paid tribute but was interrupted by CM Punk, his WrestleMania 29 opponent. Punk then mocked Bearer over the next few weeks against both The Undertaker and Kane, including stealing his urn and attacking Kane with it. On the April 1 episode of Raw, Paul Heyman dressed up as Paul Bearer and Punk poured the ashes of the urn onto The Undertaker after attacking him. At WrestleMania 29, The Undertaker defeated Punk and took back the urn, dedicating his victory to Paul Bearer.
On the March 3, 2014 episode of Raw, it was announced that Paul Bearer would be inducted into the WWE Hall of Fame. At the ceremony itself, Kane inducted Bearer, and his sons accepted the induction. Afterwards, The Undertaker came out in character and paid tribute.