She began to compose traditional Hawaiian music in 1946, choreographing hula to accompany many of her chants, and founded Hālau O Kekuhi in 1953.

[2] Kanakaʻole did not finish middle school, later joking that her formal education ended at "seventh grade and a half".

Her mother was a hula teacher and began instructing her from a young age;[2] she later studied under Akoni Mika.

[6] In the early 1950s, Kanakaʻole toured the contiguous United States, western Canada, and much of Asia with a hula group named after her daughter Nalani.

[2] Kanakaʻole originated a distinct style of hula derived from the traditions of the Hilo area, in which dancers perform with deeply bent knees and make dynamic movements.

[16] At both schools, she created courses and seminars on subjects including ethnobotany, Polynesian history, genealogy, and Hawaiian chant and mythology.

[20] In a press release announcing the honor, the United States Mint stated that Kanakaʻole's "moʻolelo, or stories, served to rescue aspects of Hawaiian history, customs and traditions that were disappearing due to the cultural bigotry of the time".