At the age of 8, Van Patten's first role was on the crime drama television series The Sopranos, for which her father directed. He got her the audition, and she portrayed Ally, the daughter of gangster Eugene Pontecorvo. She was in a 2014 episode of another series directed by her father, Boardwalk Empire. She deferred admission to the University of Southern California, instead choosing to audition in New York City and take community college classes in psychology and philosophy. She postponed the courses, however, when she got a job during the school year. She met her manager, Emily Gerson Saines, through LaGuardia classmate and actor Ansel Elgort.

Van Patten played Ellie in her first feature film, the Netflix romantic comedy Tramps, which premiered at the 2016 Toronto International Film Festival. She had a small part in crime drama Stealing Cars and starred in the 2017 horror thriller Central Park. In the comedy-drama film The Meyerowitz Stories (New and Selected), Van Patten portrayed Eliza, a Bard College film student and the daughter of Adam Sandler's character, Danny. In the film, directed by Noah Baumbach and screened at the 2017 Cannes Film Festival, Eliza makes sexually explicit shorts starring herself.

She will appear in David Robert Mitchell's crime noir Under the Silver Lake with Mamet, Riley Keough, and Andrew Garfield. She will also star opposite Jovan Adepo in Kerem Sanga's drama The Violent Heart. Van Patten was named one of Variety magazine's "10 Actors to Watch" in 2017.