Elvstrøm won the Firefly sailing class in 1948. This class evolved into the Finn monotype class, which Elvstrøm then won in 1952, 1956 and 1960. After being a reserve on the Danish team in 1964, he competed in 1968 and 1972. Although he did not win a medal, he did place fourth in the 1968 Star class competition.
Elvstrøm returned to the Olympic Games in 1984 and 1988 when his daughter, Trine, crewed for him, making them the only father/daughter combination to have competed together at the Games. Trine and Paul Elvstrøm were European champions in the Tornado class in 1983-84 and placed fourth in this class at the 1984 edition of the Games. Paul Elvstrøm also won 13 World Championships in seven different monotype sailing classes. He is one of only four Olympic athletes to have competed over a 40-year span.