Born in Perth Amboy, New Jersey, he was most active between about 1910 and 1930, often collaborating with the lyricist Joseph McCarthy. His mother was a pianist, his father a trumpeter, and he himself toured as a concert pianist in his early years. After a brief spell working in London for a music publisher, he returned to the United States in 1916. Over the next couple of decades many of his songs were used in the famous Ziegfeld Follies, and were performed by the premier singers of the day, such as Eddie Cantor, Anna Held and Edith Day.
The year 1919 saw his greatest Broadway hit, the show Irene, which contained perhaps his most well-known song, "Alice Blue Gown", as well as "Castle of Dreams," an adaptation of Chopin's Minute Waltz. This same show was made into a film in 1926, then remade in 1940 with Anna Neagle and Ray Milland, and again for the stage in 1973 with Debbie Reynolds. The original show broke the then record for the longest running show, at 620 performances.
Other shows followed with varying success, in particular, Rio Rita (collaborating with Joseph McCarthy, and one of RKO's first forays in converting a musical to the silver screen), and Kid Boots, Dixiana (1929) and Half Shot at Sunrise (1930) were also made into films. Tierney's successes after this period were sketchy (apart from the film remakes of Irene), but he was elected into the Songwriter's Hall of Fame.
Harry Tierney is interred at Holy Sepulchre Cemetery in New Rochelle, New York.