Luke Whitehead had 17 points and 14 rebounds as 16th-ranked Louisville nearly squandered a 12-point lead in the final 5 1/2 minutes before holding on for an 83-78 win over the Blazers in the championship game of the Conference USA tournament.
The Cardinals (24-6), who have won two national championships in their history, will return to the NCAA Tournament after a two-year absence. It also marks a return to the tournament for second-year coach Pitino, who was last there in 1997 when he took Kentucky to the Final Four.
Leading the way was Whitehead, who was named the tournament's Most Valuable Player and needed the prodding of Pitino to excel.
"I told Luke that tonight you're a power forward," Pitino said. "That doesn't mean that you can't score, but you need to hustle, rebound and play great defense. Two weeks ago, I told him he was going to sit his senior year so he might want to go elsewhere if he doesn't want to play power forward. He said he didn't want to go elsewhere. He loved it here."
Freshman Francisco Garcia sank two free throws to put Louisville up, 72-60, with 5:29 left.
But a three-point play by Sidney Ball with 1:49 left cut the deficit to 76-73. After Louisville's Kendall Dartez sank two free throws, Morris Finley hit a three-pointer with 1:33 left to cut the lead to 78-76.
Garcia made one of two free throws and Alabama-Birmingham's Demario Evans sank two shots from the line to cut the lead to one.
Louisville's Taquan Dean turned the ball over, but the Blazers were able to get off only an awkward shot by Finley on a fast break and Louisville regained possession with 25 seconds left.
The Blazers allowed Louisville to easily tick 11 seconds off the clock before Reece Gaines was fouled and hit a pair of free throws.
Alabama-Birmingham trailed only by three, but Eric Bush stunningly bypassed a long-range shot and drove for a layup that missed and was rebounded by Whitehead.
"(Finley) and I talked about it and I was trying to get a quick basket," Bush said. "I penetrated to his side to see if they were going to help and they didn't do so, so I just tried to finish the layup and unfortunately it didn't fall."
Two free throws by Whitehead accounted for the final margin and gave the Cardinals their first Conference USA title.
"It's been a little bit of a roller coaster, but my father told me that icicles make you stronger," Whitehead said. "Coach Pitino has made me a stronger player."
Finley had 20 points for Alabama-Birmingham (19-12), which had won three straight in the tournament after ending the regular season with a three-game losing streak.
"We were in a position to have a chance to win tonight and we didn't finish it off," Alabama-Birmingham Coach Mike Anderson said.
The Cardinals overcame a sub-par effort by Gaines, the third-leading scorer in the conference who was held scoreless in the first 31 minutes and and was held to a season-low eight points.
Dean scored 15 points, but made just six of 17 shots, and Garcia netted 14 for the Cardinals.
Louisville also overcame a huge game from UAB's Demario Eddins, who had 18 points and 12 rebounds.
The score was tied four times and there were nine lead changes by halftime, when the Blazers led, 37-35.
Both teams shot just 37 percent.