Tsai's artistic practice has two major themes: an "introspective" method centered on Buddhist philosophy that combines calligraphy, painting, photography, performance and video art; and "social" action documenting indigenous peoples and traditions, marginalized individuals and communities, and environmental and cultural issues.

[1][9] In 2009, she wrote the sutra on mushrooms in collaboration with Buddhist monks and nuns for the Asia Pacific Triennial in Brisbane, Australia;[6][8] and inscribed a text by literary critic Elaine Scarry on flower petals for an installation at the Church of Saint-Séverin in Paris.

[6] Her exhibition Meeting Point (Edouard Malingue Gallery, Hong Kong, 2014), alongside Taiwanese artist Wu Chi-Tsung, showed photographs and video of incense burning and becoming ashes.

[7] Tsai participated in the 2016 Biennale of Sydney with an installation in the city's Mortuary Station, which included large incense coils bearing the Hundred Syllable Mantra, and a video work titled Bardo based on the Tibetan Book of the Dead.

[3][7][10][11][12][13] Bardo was shown at Tsai's solo exhibition Universe of Possibilities (TKG+, Taipei, 2016), which also featured planet-like macro photographs of sea shells discarded from Vietnamese fishing boats.

[3][14] Tsai's first solo exhibition in the U.K., Bulaubulau (Centre for Chinese Contemporary Art, Manchester, 2018) displayed large pieces of driftwood from Taiwan inscribed with the sutra, and watercolor paintings with the Buddhist text inked on rice paper.

[17][18] For the group exhibition The Power of Intention: Reinventing the (Prayer) Wheel (Rubin Museum of Art, New York, 2019), Tsai contributed an ink painting and an installation of spiral incense coils.

Lanyu Seascapes describes the externalities of a nuclear waste storage facility on the island, while Shi Na Paradna depicts an elderly man reciting a prayer ritual by the sea, and Hair Dance documents a ceremonial performance by the women of the tribe.

[4] Bulaubulau (2018) documents the efforts of an indigenous village in Yilan County, Taiwan to sustainably maintain both tradition and modern life in the face of natural disasters, industrialization, and economic upheaval.