Ramalho made his league debut on 20 July 2013 against SC Wiener Neustadt. He played the full game. On 27 July 2013, he scored his first goal for RB Salzburg against FK Austria Wien in a 5–1 win. He scored his second goal against SV Grödig at 10 August 2013.
He signed a three-year contract with PSV on 26 May 2021. This will be the third club where he is under the tutelage of Roger Schmidt, next to Red Bull Salzburg and Bayer Leverkusen.[3]