Fountain earned a B.A. in English from the University of North Carolina at Chapel Hill in 1980, and a law degree from the Duke University School of Law in 1984. After a brief stint practicing real estate law at Akin Gump in Dallas, Fountain became a full time fiction writer.

He is the author of Brief Encounters With Che Guevara, a collection of short stories. He has won numerous awards, including the Texas Institute of Letters Short Story Award for 2002 and 2004, a Pushcart Prize in 2004, an O. Henry Award in 2005 and 2007, and inclusion of his work in New Stories from the South: The Year's Best (2006. In 2007 he won the Hemingway Foundation/PEN Award for a distinguished first book of fiction, and a Whiting Writers Award, a prestigious award for emerging writers, from the Mrs. Giles Whiting Foundation.

His first published novel, The Texas Itch, is scheduled to appear in 2009.