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A protégé of Pier Paolo Pasolini, Bertolucci made his directorial debut at 22. His second film, Before the Revolution (1964), earned strong international reviews and has since gained classic status, being called a "masterpiece of Italian cinema" by Film4. His 1970 film The Conformist, an adaptation of the Alberto Moravia novel, is considered a classic of international cinema, and was nominated for an Academy Award for Best Adapted Screenplay and the prestigious Berlin Golden Bear. His 1972 erotic drama Last Tango in Paris was controversial due to its rape scene and, later, comments made by actress Maria Schneider about her treatment on set. Bertolucci's later films such as the historical epic 1900 (1976), the family drama La Luna (1979), and the darkly comedic Tragedy of a Ridiculous Man (1981), were also controversial but acclaimed.

His 1987 film The Last Emperor, a biopic of Chinese monarch Puyi, was a critical and commercial success, earning rave reviews and sweeping the 60th Academy Awards (including Best Picture and Best Director). This was the start of what has since been described as his "Oriental Trilogy", a trio of films including The Sheltering Sky, an adaptation of the novel of the same name, and Little Buddha, a Buddhist religious epic, all three of which feature scores by Ryuichi Sakamoto. His 1996 film, Stealing Beauty, brought him his second of two Palme d'Or nominations. He continued directing well into the 21st century, releasing his final film, Me and You, in 2012.

Bertolucci's films often deal with themes of politics, sexuality, history, class conflict and social taboos, and his style has influenced several filmmakers. Several of his films have appeared on lists of the greatest films of all time. Critics have remarked that what makes Bertolucci different than other directors is his masterful combination of "visual richness and visual freedom".