From 2003 through 2006, Ewing was an assistant with the Houston Rockets, before resigning to spend more time with his family.
On July 3, 2007, Ewing was one of four assistants hired to serve under first-year Orlando Magic head coach Stan Van Gundy for the 2007–08 season.

Ewing was a key factor in the Magic's run to the 2009 NBA Finals, where they lost to the Los Angeles Lakers.
He correctly predicted a win in Game 7 of the second round against the defending champion Boston Celtics.
The Magic beat the Celtics 101 to 82 to win the series 4–3.
As a result, Ewing saw Magic captain Dwight Howard set a new NBA Finals record, for most blocked shots in a single finals game, with 9 in Game 4 of the finals, surpassing the previous record of 8, which Ewing himself set in Game 5 of the 1994 Finals.

In 2010, Ewing finally got the opportunity to coach his son Patrick Ewing Jr. in the 2010 summer league.
Ewing Jr. played for the Magic.

In 2013, Ewing became an assistant coach with the Charlotte Bobcats (now Charlotte Hornets).
On November 8, 2013, Ewing would end up coaching for the Bobcats as their interim head coach due to the team's regular head coach Steve Clifford having heart surgery during that time.
He would end up losing in his first stint by the score of 101–91 against his former team, the New York Knicks.

On April 3, 2017, Ewing was hired as head coach of his former college team, the Georgetown Hoyas.
In his first season as head coach, the Hoyas were 15–15 (5–13 in the Big East).
The season ended without any postseason tournament play.
In Ewing's second season Georgetown was 19–14, and finished tied in third place in the Big East with a 9–9 record.
The Hoyas were awarded a bid into the National Invitational Tournament, their first postseason tournament since 2015.
James Akinjo was named the Big East Rookie of the Year, and fellow freshmen Mac McClung and Josh Leblanc joined him on the All-Freshman Team.
From 2003 through 2006, Ewing was an assistant with the Houston Rockets, before resigning to spend more time with his family. On July 3, 2007, Ewing was one of four assistants hired to serve under first-year Orlando Magic head coach Stan Van Gundy for the 2007–08 season.
Ewing was a key factor in the Magic's run to the 2009 NBA Finals, where they lost to the Los Angeles Lakers. He correctly predicted a win in Game 7 of the second round against the defending champion Boston Celtics. The Magic beat the Celtics 101 to 82 to win the series 4–3. As a result, Ewing saw Magic captain Dwight Howard set a new NBA Finals record, for most blocked shots in a single finals game, with 9 in Game 4 of the finals, surpassing the previous record of 8, which Ewing himself set in Game 5 of the 1994 Finals.
In 2010, Ewing finally got the opportunity to coach his son Patrick Ewing Jr. in the 2010 summer league. Ewing Jr. played for the Magic.
In 2013, Ewing became an assistant coach with the Charlotte Bobcats (now Charlotte Hornets). On November 8, 2013, Ewing would end up coaching for the Bobcats as their interim head coach due to the team's regular head coach Steve Clifford having heart surgery during that time. He would end up losing in his first stint by the score of 101–91 against his former team, the New York Knicks.
On April 3, 2017, Ewing was hired as head coach of his former college team, the Georgetown Hoyas. In his first season as head coach, the Hoyas were 15–15 (5–13 in the Big East). The season ended without any postseason tournament play. In Ewing's second season Georgetown was 19–14, and finished tied in third place in the Big East with a 9–9 record. The Hoyas were awarded a bid into the National Invitational Tournament, their first postseason tournament since 2015. James Akinjo was named the Big East Rookie of the Year, and fellow freshmen Mac McClung and Josh Leblanc joined him on the All-Freshman Team.
Patrick Ewing