Joey turned professional at the age of 18, after having enlisted in the 82nd Airborn Division at age 16. Being under age, he used his friend, Joey Giardello's birth certificate to enlist. The name stuck for his entire career.

When Joey was 21, he beat Billy Graham to earn him #5 ranking in the Middleweight division in his 54'th fight. He would remain in the Top Ten of the Middleweight division for fourteen years following the Graham fight.

He fought for 12 years before getting his first title fight against Gene Fullmer. The Fullmer style was to fight with both hands & the top of his head. With a history of cutting easily, Joey coped with Fullmer's head butting style for a couple of rounds before Joey made it a butting contest. The fight ended in a draw in Bozeman, Montana, Fullmer's backyard. The head butt caused Fullmer to stop using his head. One of boxing's unanswered questions is would an earlier butt have made Fullmer change his style earlier & won the fight for Joey? The head butt made Fullmer swear he would never fight Joey again. He didn't.

The Fullmer fight took place on April 20, 1960. It was to be three and a half years before Joey got his next chance at the title. On December 7, 1963, Joey fought Middleweight Champion Dick Tiger. The Tiger-Giardello took place at the Convention Center in Atlantic City on a cold wintery night. Tiger, a straight ahead, punishing body puncher, had a long night because Joey was in the best shape of his life. Feinting, countering, putting on the performance of a lifetime, winning comfortably.

After a couple of tune-up fights, Joey defended his title against Rubin "Hurricane" Carter, a one punch knockout artist many years younger than Joey. Joey simply out-boxed the feared Hurricane and won easily.

On April 23, 1965, Joey fought Gil Diaz donating his entire purse to the St. John of God School for Special Children. Even today Joey continues his fight for special causes making him a true "Lifetime Champion"