In 1996–2009 Pihlajaniemi was Scientific Director of Biocenter Oulu. She was the Founding Director of Biocenter Finland in 2006–2007. Pihlajaniemi was Director of the Academy of Finland Centre of Excellence for Cell-Extracellular Matrix Research in 2012–2017. She was post-doctoral scientist at the University of Medicine and Dentistry - Rutgers Medical School, New Jersey, U.S.A., in 1982-1985. Pihlajaniemi graduated as Doctor of Medicine in 1987 and was appointed Professor of Medical Biochemistry in 1990 at University of Oulu. She has served in many national and international positions of trust. Pihlajaniemi is a scientific co-founder of FibroGen Inc.