Ada Rovatti was born on July 25, 1976, in Pavia, in Lombardy, and grew up in the nearby town of Mortara. Her father, Mario Rovatti, nicknamed her "Piloo" after a mischievous cat in a children's book, a name she carried into adulthood and later gave to her own record label. She began on classical piano, then switched to saxophone at sixteen after her brother introduced her to American soul, blues and R&B records.

A scholarship took her to the Berklee College of Music, where she divided her time between Boston, studying with Joe Viola, George Garzone and Fred Lipsius, and Italy, where she worked regularly in big bands alongside visiting American players including Phil Woods and Lee Konitz. After Berklee she spent a year based in Paris, touring Europe and Africa, before relocating to New York City in the late 1990s.

In 1996, trumpeter Randy Brecker traveled to Italy to perform with a local big band and met Rovatti there. They married in December 2001. The following two years brought her New York career into focus: in 2003 she released her first two albums as a leader, For Rent with the Elephunk Band and Under the Hat with a quartet featuring Brecker, Mike Stern and drummer Don Alias as guests, and she appeared on Brecker's own 34th N Lex, which won a Grammy Award that year. Airbop followed in 2006, the same year she recorded on John McLaughlin's Industrial Zen.

Michael Brecker, Randy's brother and the other half of the Brecker Brothers, died of leukemia on January 13, 2007. In the years that followed, Rovatti took the tenor saxophone chair in the reunited Brecker Brothers Band Reunion, touring with the group and recording a live double DVD and CD at the Blue Note Jazz Club in New York. In 2009 she founded her own label, Piloo Records, releasing Green Factor as its first title, and followed it with Disguise in 2014.

In 2019, Randy Brecker released Brecker Plays Rovatti: Sacred Bond, an album made up entirely of her compositions, co-billed to both of them. The same year she is featured on his Rocks, recorded with the NDR Bigband alongside saxophonist David Sanborn, which won Brecker his seventh Grammy Award, for the improvised solo on "Sozinho," at the 2020 ceremony. In 2021, the WDR Big Band in Cologne invited her to a special concert titled "4 Tenors," performing alongside three established American saxophonists, Bob Mintzer, Bob Malach and Paul Heller.

Her most recent album as leader, The Hidden World of Piloo, is dedicated to her father, who died during the COVID-19 pandemic; released on her own Piloo Records, it moves between funk, gospel and waltz forms with guest vocalists including Kurt Elling, Fay Claassen, Niki Haris and Alma Naidu. According to her own published biography, her wider list of recording and performing credits includes Herbie Hancock, Aretha Franklin, Joe Bonamassa, James Moody and Joanne Brackeen, and she appeared on screen in the 2003 film Mona Lisa Smile. She has performed at the JVC Jazz Festival in New York, the Rochester International Jazz Festival, the Detroit Jazz Festival, the Montreal Jazz Festival, the San Francisco Jazz Festival and the North Sea Jazz Festival, and is a regular performer on the annual Jazz Cruise.

Rovatti's playing and writing sit in the funk- and fusion-inflected wing of contemporary jazz, built around a tenor sound developed under two of Berklee's best-known saxophone teachers, Joe Viola and George Garzone, and shaped early by an apprenticeship in Italian big bands playing opposite Phil Woods and Lee Konitz. Her own albums move between hard-grooving jazz-funk (the Elephunk Band records, Green Factor), more polished contemporary and smooth-jazz production (Airbop, Disguise), and, on The Hidden World of Piloo, an expanded palette of funk, gospel and waltz forms built around guest vocalists and a string arrangement, a departure she has described as her most personal record.

As a sideman she works across a wide stylistic range, from Randy Brecker's brass-driven fusion and the NDR Bigband's big-band arrangements to John McLaughlin's guitar-led fusion and long-running session work for Italian pop singer Mina. Since taking the tenor chair in the reunited Brecker Brothers Band after Michael Brecker's 2007 death, she has also carried forward one of jazz-funk's signature ensemble sounds in a live setting, a role she has held long enough to be invited to sit in with other established chair-holders, as at the WDR Big Band's 2021 "4 Tenors" concert.