On 12 August 2009, it was announced that Cattermole had completed a medical at Sunderland and signed for a fee of £6 million.
The midfielder joined the club on a four-year contract, reuniting with former Wigan coach Steve Bruce.
He made his debut in a 1–0 win over Bolton Wanderers, in which he won Sunderland's Man of the Match award.
He then in the next few games of the season became popular amongst the fans despite missing several games with a heel injury.
On 17 October 2009, he injured his knee in the win over Liverpool and was ruled out for twelve weeks.
He returned as a second-half substitute for Jordan Henderson on 15 December in a 2–0 loss against Aston Villa.
He then played the full match and captained the side in the 4–3 defeat by Manchester City.

On the eve of the 2010–11 season, Cattermole was selected by manager Bruce as the replacement captain after Lorik Cana's departure.
He was also handed the vacant number 6 shirt.
He received a red card in the first game of the season against Birmingham City for a second bookable offence.
Bruce later referred to referee Anthony Taylor as 'out of his depth'.
Cattermole played most of the 90 minutes in Sunderland's 3–0 away win against Chelsea, coming off in added time in the second half and was pivotal in the victory.
He then earned the Man of the Match award for his performance at home to West Ham, a game which Sunderland won 1–0.
Cattermole's tough tackling style has put him into troublesome situations with referees.
Bruce, despite backing Cattermole as club captain, said that his disciplinary record must improve.
Again, Cattermole suffered an injury-hit season, making 24 appearances in total (two more than the previous season).

Cattermole remained captain at the start of the 2011–12 season and received yellow cards in the first two games, against Liverpool and Newcastle.
He then fell out of favour, with his next full match not coming until 5 November, in a defeat at Manchester United.
Following Bruce's sacking and the appointment of Martin O'Neill as his successor, it was suggested Cattermole might lose the captaincy, especially after he and Nicklas Bendtner were arrested for allegedly damaging cars in Newcastle city centre.
However, he led the team on his first appearance under O'Neill, a 3–2 win at QPR.
Cattermole had arguably two of his best performances for the Black Cats in their 1–0 win over Manchester City on New Years Day 2012 and a 4–1 win at Wigan two days later.
After the victory over Manchester City, O'Neill told his captain: "Well done, absolutely brilliant.
You've got a heart like a lion".
The skipper also put in another excellent defensive performance in the FA Cup fifth-round game against Arsenal on 18 February.
Cattermole and his teammates constantly pressed the Arsenal players when they had possession, forcing mistakes and with counter-attacking football, the Black Cats won 2–0.

On 4 March 2012, Cattermole was booked in the first minute of the Tyne-Wear derby for a challenge on Newcastle's Cheick Tioté.
He received a red card at the conclusion of the match after confronting referee Mike Dean.
Martin O'Neill described Cattermole's sending off as "foolish" but claimed Newcastle were "lucky" to finish with 11 players.
Cattermole received a four-match ban for the incident.
During his ban, reports suggested that O'Neill would strip Cattermole of the captaincy because of his behaviour at the Tyne-Wear Derby match but O'Neill denied the claims.
After serving his ban, Cattermole made his return for Sunderland on 27 March in the FA Cup quarter-final replay against Everton, a match Sunderland went on to lose 2–0.
Through 73 games for Sunderland in all competitions, Cattermole had been booked 32 times and received four red cards.

The start of the 2013–14 season saw Cattermole replaced as captain by John O'Shea and his number 6 shirt handed to new signing Cabral.
Cattermole was assigned the number 33 jersey.
He scored his first league goal for Sunderland in a 5–1 loss to Tottenham Hotspur at White Hart Lane on 7 April 2014.

Cattermole regained his number 6 shirt a
On 12 August 2009, it was announced that Cattermole had completed a medical at Sunderland and signed for a fee of £6 million. The midfielder joined the club on a four-year contract, reuniting with former Wigan coach Steve Bruce. He made his debut in a 1–0 win over Bolton Wanderers, in which he won Sunderland's Man of the Match award. He then in the next few games of the season became popular amongst the fans despite missing several games with a heel injury. On 17 October 2009, he injured his knee in the win over Liverpool and was ruled out for twelve weeks. He returned as a second-half substitute for Jordan Henderson on 15 December in a 2–0 loss against Aston Villa. He then played the full match and captained the side in the 4–3 defeat by Manchester City.
On the eve of the 2010–11 season, Cattermole was selected by manager Bruce as the replacement captain after Lorik Cana's departure. He was also handed the vacant number 6 shirt. He received a red card in the first game of the season against Birmingham City for a second bookable offence. Bruce later referred to referee Anthony Taylor as 'out of his depth'. Cattermole played most of the 90 minutes in Sunderland's 3–0 away win against Chelsea, coming off in added time in the second half and was pivotal in the victory. He then earned the Man of the Match award for his performance at home to West Ham, a game which Sunderland won 1–0. Cattermole's tough tackling style has put him into troublesome situations with referees. Bruce, despite backing Cattermole as club captain, said that his disciplinary record must improve. Again, Cattermole suffered an injury-hit season, making 24 appearances in total (two more than the previous season).
Cattermole remained captain at the start of the 2011–12 season and received yellow cards in the first two games, against Liverpool and Newcastle. He then fell out of favour, with his next full match not coming until 5 November, in a defeat at Manchester United. Following Bruce's sacking and the appointment of Martin O'Neill as his successor, it was suggested Cattermole might lose the captaincy, especially after he and Nicklas Bendtner were arrested for allegedly damaging cars in Newcastle city centre. However, he led the team on his first appearance under O'Neill, a 3–2 win at QPR. Cattermole had arguably two of his best performances for the Black Cats in their 1–0 win over Manchester City on New Years Day 2012 and a 4–1 win at Wigan two days later. After the victory over Manchester City, O'Neill told his captain: "Well done, absolutely brilliant. You've got a heart like a lion". The skipper also put in another excellent defensive performance in the FA Cup fifth-round game against Arsenal on 18 February. Cattermole and his teammates constantly pressed the Arsenal players when they had possession, forcing mistakes and with counter-attacking football, the Black Cats won 2–0.
On 4 March 2012, Cattermole was booked in the first minute of the Tyne-Wear derby for a challenge on Newcastle's Cheick Tioté. He received a red card at the conclusion of the match after confronting referee Mike Dean. Martin O'Neill described Cattermole's sending off as "foolish" but claimed Newcastle were "lucky" to finish with 11 players. Cattermole received a four-match ban for the incident. During his ban, reports suggested that O'Neill would strip Cattermole of the captaincy because of his behaviour at the Tyne-Wear Derby match but O'Neill denied the claims. After serving his ban, Cattermole made his return for Sunderland on 27 March in the FA Cup quarter-final replay against Everton, a match Sunderland went on to lose 2–0. Through 73 games for Sunderland in all competitions, Cattermole had been booked 32 times and received four red cards.
The start of the 2013–14 season saw Cattermole replaced as captain by John O'Shea and his number 6 shirt handed to new signing Cabral. Cattermole was assigned the number 33 jersey. He scored his first league goal for Sunderland in a 5–1 loss to Tottenham Hotspur at White Hart Lane on 7 April 2014.
Cattermole regained his number 6 shirt a
Lee Cattermole