Pieczenik was born in Cuba of Jewish parents from Russia and Poland and was raised in France. His father, a doctor from Dombrovicz who studied and worked in Toulouse, France, fled Poland before World War II. His mother, a Russian Jew from Bialystok, Poland, fled Europe after many of her family members were killed. The couple met in Portugal, where both had fled ahead of the Nazi invaders. Pieczenik was born in Cuba in 1943. After living in Toulouse for six years, Pieczenik's family migrated to the United States, where they settled in the Harlem area of New York City, New York. Steve Pieczenik was eight years old when his parents received their entry visa to the US.
Pieczenik is a classical pianist and wrote a full-length musical at the age of eight.
Pieczenik is a Harvard University-trained psychiatrist and has a doctorate in international relations from the Massachusetts Institute of Technology (MIT).
Pieczenik's autobiography notes that he attended Booker T. Washington High School in the Harlem neighborhood of New York City. Pieczenik received a full scholarship to Cornell University at the age of 16. According to Pieczenik, he received a BA degree in Pre-Medicine and Psychology from Cornell in 1964, and later attended Cornell University Medical College. He attained his PhD in international relations from MIT while studying at Harvard Medical School. Pieczenik claims to be the first psychiatrist ever to receive a PhD focusing on international relations.
While doing his psychiatric residency at Harvard, he was awarded the Harry E. Solomon award for his paper entitled: "The hierarchy of ego-defense mechanisms in foreign policy decision making".
An article written by Pieczenik, "Psychological dimensions of international dependency", appears in the American Journal of Psychiatry, Vol 132(4), Apr 1975, 428-431.