Andrea Bertolacci started his career with the Roma academy. In January 2010 he was sent on loan to Serie A team, Lecce. He scored the first goal for Lecce against Juventus a game in which he scored a brace. In summer 2010, Lecce extended the loan and borrowed Simone Sini also from Roma.
On 22 June 2011, Lecce excised the option to purchase 50% of his registration rights for a pre-agreed fee of €500,000. However, Roma excised the rights against the option for €500,000. Thus, Lecce received €500,000 in net as an incentive for the loan. Then Andrea Bertolacci was loaned for another season to Lecce, in order to play as a regular and gain more experience.
Bertolacci scored against his parent club in a 2–1 defeat on 20 November 2011.On 30 June 2012, Andrea Bertolacci returned to Roma. In summer 2012 he was involved in the deal to sign Genoa’s Panagiotis Tachtsidis. 50% of Bertolacci’s player rights were tagged for €1 million and also 50% of Tachtsidis’s rights for €2.5 million.
On 20 June 2014, Roma and Genoa renewed their co-ownership contract agreement with Andrea Bertolacci.
2014-2015 season with Genoa is Bertolacci’s best season of his career. He scored 6 goals in 34 matches of Serie A, producing 8 assists and helping his team reaching the 6th place in the league.