He previously represented Tabriz, Osku and Azarshahr electoral district in the Parliament of Iran, and also served as its First Deputy Speaker from 2016 to 2020. He was Minister of Health and Medical Education between 2001 and 2005 in the Government of Mohammad Khatami.
Pezeshkian was elected governor of Piranshahr and Naghadeh counties in West Azerbaijan province during the 1980s. He ran in the 2013 presidential election, but withdrew. He ran again in the 2021 election, but was unsuccessful.
For the 2024 election, Pezeshkian’s candidacy was approved and on 5 July, he won the 2024 presidential election in a runoff with 54.76% of the popular vote. He was formally appointed as the President of Iran on 28 July 2024. He is the oldest person to take the office of President of Homeland, at the age of 69 years.