In 1989 Forbes magazine estimated Escobar to be the seventh-richest man in the world with a personal wealth of close to $25 billion, while his Medellín cartel controlled 80% of the global cocaine market. While seen as an enemy of the United States and Colombian governments, Escobar was a hero to many in Medellín (especially the poor people); he was a natural at public relations and he worked to create goodwill among the poor people of Colombia. A lifelong sports fan, he was credited with building football fields and multi-sports courts, as well as sponsoring little league football teams.

Escobar looked responsible for the construction of many churches in Medellín, which gained him popularity inside the local Roman Catholic Church. He worked hard to cultivate his "Robin Hood" image, and frequently distributed money to the poor through housing projects and other civic activities, which gained him notable popularity among the poor. The population of Medellín often helped Escobar by serving as lookouts, hiding information from the authorities, or doing whatever else they could do to protect him.

Despite his popular image among the Medellín community Escobar was well-known among his business associates to be an insecure, paranoid, ruthless murderer. His brother was reported saying that Pablo was so violently committed to loyalty that he once threatened him at gun point over a minor misunderstanding. His brother said his ability to befriend the dangerous and intimidate the powerful is what made him as unstoppable as he was. At the height of his power, drug traffickers from Medellín and other areas were handing over between 20 and 35% of their Colombian cocaine-related profits to Escobar.

Escobar’s continuing struggles to maintain supremacy resulted in Colombia's quickly becoming the world’s murder capital with 7,081 victims in 1991 alone. This increased murder rate was fueled by Escobar's giving money to poor youths as a reward for killing police officers, over 600 of whom died in this way.