Goldsworthy was born in Minlaton, South Australia, and grew up in various Australian country towns, finishing his schooling in Darwin in the Northern Territory. He graduated in medicine from the University of Adelaide in 1974, and worked in alcohol and drug rehabilitation for several years, but, with his poetry being published in Westerly and the Friendly Street Poetry Reader, he started dividing his working time equally between general practice and writing.
Goldsworthy's novels have sold over 400,000 copies in Australia alone, and, with his poetry and short stories, have been translated into many European and Asian languages. He has won major literary prizes across most genres: for poetry, the short story, the novel, plays and opera.
His first novel Maestro was reissued as part of the Angus & Robertson Australian Classics series, and was voted one of the Top 40 Australian books of all time by members of the Australian Society of Authors.