Paul MacAlindin has worked throughout Europe as an orchestral conductor, education project leader and as a coach and accompanist for choirs and opera singers in Cologne.

With Psappha, the north of England's main new music group, he has conducted many concerts in the Royal Northern College of Music, the Cheltenham International Music Festival, Sonorities Festival in Belfast, Edinburgh Contemporary Arts Trust, World Music Days 1998 and the St. Magnus Festival in Orkney. He has also toured with Icebreaker Ensemble in Vienna, Warsaw Autumn Festival, Vilnius Baltic Festival, Cantiere Montepulciano and the "Cutting Edge at the Warehouse" in London. With NYOS Futures, the new music project of the National Youth Orchestra of Scotland, he has performed and presented public workshops on Julian Anderson's Khorovod and Karen Tanaka’s Wave Mechanics.

As the assistant to renowned British composer, Sir Peter Maxwell Davies, and conductor Elgar Howarth, he has worked with the Scottish Chamber Orchestra, The National Youth Orchestra of Wales, the BBC Philharmonic, the Royal Philharmonic Orchestra and the Philharmonia of London.
With the British Council, he has conducted Maxwell Davies' "The Turn of the Tide" at the Zagreb Biennale with 500 Zagreb school children and the Croatian Radio Orchestra.

He made his Carnegie Hall New York debut in 2008 accompanying Brazilian baritone Mauricio Santos Virgens. Most recently, he has worked with the Oulu Sinfonia of Finland, the New Zealand Symphony Orchestra and the Düsseldorf Symphoniker.

In 2009 he, Zuhal Sultan and Allegra Klein founded the National Youth Orchestra of Iraq, of which he is Musical Director.