Aldo Serena played for the Azzurri in the 1986 FIFA World Cup and the 1990 FIFA World Cup. In total he earned 24 caps and scored 5 goals for Italy. In Italia '90 Serena scored on his 30th birthday in Italy's 2-0 win over Uruguay but left the pitch in tears after he missed a crucial spot kick in the semi-final against Argentina, a game the home nation lost on penalties. Serena has always stated that he did not want to take a penalty in the shootout. However, as no-one else volunteered, Italian manager Azeglio Vicini had no choice but to include Serena as the final penalty kick taker.
During his career, Serena played for Montebelluna, Inter, Como, Bari, AC Milan, Juventus and Torino. He enjoyed his best with Inter Milan, in 1988–89, when he won the Scudetto and was crowned top scorer of the league, scoring 22 goals. After his move to Milan his reputation as an Inter legend was somewhat tarnished. This was shown recently when Serena's name was booed by some of Inter's Ultras supporters when announced he was to be part of an Inter Legends gathering after the final game of the 2006–07 league trophy presentation.
Serena also played for Italy at the 1984 Summer Olympics.