He was elected in 2007 with centre-left support from the Democratic Party of Japan (DPJ), People's New Party and the Social Democratic Party, defeating the centre-right supported incumbent Jun'ichi Seki by 50,000 votes.

Hiramatsu unsuccessfully ran for re-election in Osaka's mayoral election on 27 November 2011,[1] when his challenger was the former Osaka Governor Tōru Hashimoto.

[1] Despite support from both major Japanese national parties (the DPJ and the Liberal Democratic Party), and the Japanese Communist Party retracting their candidate to support his re-election bid, Hiramatsu lost to Hashimoto by a margin of well over 200,000 votes.

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