During the First World War he served as a regimental medical officer on the Western Front.

In 1939 he earned the academic degree of Professor and the same year conducted a successful lobectomy in a case of pulmonary actinomycosis.

In 1943 Bakulev became head of the surgery department of the 2nd Pirogov Moscow Institute of Medicine.

On the Eastern Front of World War II, Bakulev was the chief surgeon of Moscow evacuation hospitals.

In 1948 he pioneered the surgical treatment of congenital heart disorders in the Soviet Union.