Boutsen won the "Volant V" at the André Pilette Racing School at Zolder in 1977, then took the Belgian Formula Ford 1600 championship in 1978 with 15 victories from 18 races. He progressed to Formula 3 and finished second in the European championship in 1980 behind Michele Alboreto, then was again runner-up in the European Formula 2 championship in 1981, this time behind Geoff Lees.
Alongside his single-seater work, Boutsen developed a parallel sportscar career. He entered the 1981 24 Hours of Le Mans, where his WM P81-Peugeot suffered a catastrophic suspension failure at Hunaudières at approximately 350 km/h. The resulting accident killed a marshal, Thierry Mabilat, and seriously injured two others. In 1983, Boutsen won the very first Group C race, the Monza 1000 km, co-driving a Porsche 956 with Bob Wollek. In 1985, he and Wollek — together with A.J. Foyt and Al Unser Sr. — won the Daytona 24 Hours in a Porsche 956. In 1986, racing in Group C in parallel to Formula One, Boutsen claimed the World Sportscar Championship title with the Walter Brun team, including victory in the Spa 1000 km.
Boutsen paid $500,000 to make his Formula One debut with Arrows at the 1983 Belgian Grand Prix. He failed to score in his first season but earned a strong reputation for mechanical sympathy and consistent pace relative to his experienced teammate Marc Surer. Backed by Barclay cigarettes, he remained with Arrows for three further seasons. A highlight came at the 1985 San Marino Grand Prix: Boutsen crossed the line third and, after Alain Prost's disqualification for an underweight car, was elevated to second place — his best result in Arrows colours. In 1986 he was clinched the Group C title while scoring no points in the F1 car.
The move to the works Benetton team for 1987 gave Boutsen a genuinely competitive package. He scored points in six races, including an inherited third in Adelaide after Ayrton Senna's disqualification. In 1988, alongside new teammate Alessandro Nannini in the Rory Byrne-designed B188, Boutsen scored points in ten of sixteen races despite running normally aspirated engines against turbocharged opposition. Five third-place finishes — all behind the dominant McLaren-Honda cars — and a string of consistent top-six results placed him fourth in the Drivers' Championship, the best result by any non-turbo driver.
Frank Williams signed Boutsen in 1988 to replace Nigel Mansell for the 1989 season. The Williams FW12C with its Renault V10 proved a race-winning car. Boutsen took his maiden victory at the Canadian Grand Prix in difficult wet conditions, leading after Senna's engine failed three laps from the end following a brief 360-degree spin that Boutsen somehow kept off the walls. He added three more podiums and a second victory at the rain-soaked Australian Grand Prix to close the year.
In 1990, Boutsen achieved his third and final Grand Prix win in Hungary — a lights-to-flag victory from pole position, holding off sustained late-race pressure from Alessandro Nannini and Ayrton Senna. Despite winning three races in two seasons compared to Riccardo Patrese's one, Williams chose to replace Boutsen with Nigel Mansell for 1991, believing Mansell's profile and aggression better suited a championship challenge. Boutsen finished every points-scoring opportunity in 1990 — every race he finished ended in the top six — but was nonetheless released.
Without a vacancy at a competitive team, Boutsen joined Ligier for 1991 and 1992. The JS35 was deeply uncompetitive despite a sizeable budget and Lamborghini V12 engines. Renault power arrived in 1992 and Boutsen scored a fifth-place finish in his final race for the team — his first points since Williams.
For 1993, cigarette sponsor Barclay arranged Boutsen a drive at Jordan, replacing Ivan Capelli. The car was too small for Boutsen's tall frame and young teammate Rubens Barrichello consistently outpaced him. He scored no points in ten races before Eddie Jordan ended his Formula One career at his home Belgian Grand Prix, where Boutsen retired on the first lap.
Boutsen was hired by Ford Motorsport for the Super Tourenwagen Cup in Germany from 1994, driving a factory Ford Mondeo built by Eggenberger Motorsport alongside former Williams teammate Patrese. The programme proved unsuccessful, culminating in a failed four-wheel drive development push inspired by Audi. Boutsen departed after the first four races of 1996.
He then raced sports cars in the United States for Champion Racing in a Porsche 911 GT1, finishing second in class at the 1997 Daytona 24 Hours with Bill Adam and Hans Stuck, and winning the GT-1 US Championship in 1998. A crash at Le Mans in 1999 driving a Toyota GT-One ended his racing career.
Boutsen founded Boutsen Aviation in Monaco in 1997 with his wife Daniela, specialising in the sale and acquisition of business jets. He also co-owns Boutsen Racing — run alongside his brother-in-law Olivier Lainé — which has competed in touring car and endurance categories since 1998. Boutsen also participated in ten editions of the 24 Hours of Le Mans from 1981 to 1999, finishing runner-up in 1993 with Peugeot and in 1996 with Porsche. His three Formula One victories, all achieved for Williams, represent the career peak of a driver valued for precision and reliability rather than flamboyance.