Pfeiffer, who has claimed to have a rural background, began her career in Europe, where she translated scripts for dubbing. By 1963, she was working as Claudia Cardinale's personal assistant (during the period the actress made Fellini's "8 1/2"). Pfeiffer worked briefly with actor Alain Delon as an assistant producer, then became assistant to Omar Sharif during the filming of "Doctor Zhivago" (1965). She moved to London in 1966, where she opened her own public relations firm. Eventually her clients included Barbra Streisand, Robert Redford, Liza Minnelli, the Beatles' Apple Corp., and Paul McCartney and Wings.
In 1975, Pfeiffer returned to the USA, to join Shep Gordon's fledgling Alive Enterprises as a producer. Her first effort, Alice Cooper's "Welcome to My Nightmare" was nominated for a Best Video Album Grammy, and won an Emmy for its editing. Pfeiffer, Gordon and Chris Blackwell formed Island Alive in 1983, with Pfeiffer and Gordon as co-chairs. The company would release such films as Gregory Nava's "El Norte" (1983), "Koyaanisqatsi" (1982) and "Kiss of the Spider Woman" (1985), which earned William Hurt a Best Actor Oscar. Alive Films was formed in 1985 specifically for film production. Through Alive Films, Pfeiffer was producer of Lindsay Anderson's "The Whales of August" (1987) which teamed Bette Davis, Lillian Gish and Ann Sothern, and Nava's "A Time of Destiny" (1988). Some productions did less well, such as "Cool as Ice" (1991), a chance to bring Caucasian rapper Vanilla Ice to the big screen, and Sam Shepard's "Silent Tongue" (1993). Pfeiffer left Island in the early 90s and subsequently co-produced the musical thriller "Kla$h" (1995).
Pfeiffer has had a few forays into TV. In 1992, she produced "Grand Isle", the story of an unhappily married woman and her involvement with a younger man. Although made with a theatrical run in mind, the film, which starred Kelly McGillis, eventually found a home on TNT.