Barbara Goldbach was born to Howard and Marjorie Goldbach in Queens, New York. Her father was a policeman. She met her first husband Augusto Gregorini in New York while she worked as a model and he was visiting from Italy for business tourism in 1966. Barbara followed him to Italy to be with him and they married in 1968. They had two children, Francesca Gregorini and Gianni Gregorini. During Gianni's birth, he had the umbilical cord wrapped around his neck, nearly choking him, and was diagnosed with cerebral palsy, although a later operation improved his condition.

In 1975, Barbara and Augusto Gregorini separated when she moved to Los Angeles, California. The couple separated in 1978, sharing custody of their two children. Barbara met Ringo Starr on the set of the comedy Caveman (1981), and they became a couple during the filming. Ringo and Barbara were on a holiday in December 1980 when her daughter called to inform them that John Lennon had been shot. Ringo and Barbara went to New York City to console Yoko Ono and Sean Lennon. Ringo and Barbara married on April 27, 1981.

Her acting career began in Italy, where she played Nausicaa in Odissea (1968), a television adaptation of Homer's epic poem "The Odyssey", directed by Franco Rossi and produced by Dino De Laurentiis. Bach co-starred with two other "Bond Girls", Claudine Auger and Barbara Bouchet in the mystery La tarantola dal ventre nero (1971) and had small roles in other Italian films. In 1977, she played Russian secret agent Anya Amasova in the James Bond film The Spy Who Loved Me (1977). The following year, she appeared in the war film Force 10 from Navarone (1978), which also starred Robert Shaw and Harrison Ford.