He studied medicine in Berlin, Würzburg and Vienna, earning his doctorate in 1858. From 1859 he worked in Berlin, where he later became an assistant to Wilhelm Griesinger (1817-1868). In 1879 he replaced Heinrich Curschmann (1846-1910) as director of the Moabit Hospital, where one of his students was pediatricianHugo Neumann (1858-1912). From 1885 to 1893 he was an editor of the Journal für praktische Aerzt.
He is remembered for work with neurologistAlbert Eulenburg (1840-1917) involving research of the sympathetic nervous system. With Eulenburg he published Die Pathologie des Sympathicus auf physiologischer Grundlage, a work that was considered at the time to be the best written book on the pathology of the sympathetic system from a physiological basis. As a result of this publication, the two physicians were awarded the 1877 Astley Cooper Prize. However, this honor was later overturned due to a technicality that the book had two authors.
Die Pathologie des Sympathicus auf physiologischer Grundlage, Albert Eulenburg and Paul Guttmann - Essay on the sympathetic nervous system.
"A handbook of physical diagnosis: comprising the throat, thorax, and abdomen"; by Paul Guttmann, translated from the third German edition by Alex Napier.