Aleksandr Gerasimov began his ice hockey career with Dizelist Penza in 1978, before a move to CSKA Moskva in 1980, where he stayed until the end of his career in 1988. With CSKA, he won seven Soviet and European Champions’ Cup titles (1981-87). Internationally, Gerasimov played for the Soviet national team in just one major tournament, the 1984 Olympic Games where he won a gold medal. He played in seven matches, scored two goals, and had three assists.
During a training session with a barbell in 1987, Gerasimov had an accident and received a spinal injury. However, after treatment, he was able to return to the ice to help CSKA win their seventh title. Before the start of the next season, Gerasimov was found to have a deformed spine and he announced his retirement. He then worked as a coach and head of the hockey school at CSKA.