Her work was discussed in academic literature for breaking the norms of shōjo manga of the 1970s with depictions of female sexuality as well as for capturing the zeitgeist of her native Tokyo at the time of writing.
In 1985, after graduating from college, she published her first manga series Virgin, and in 1989, she wrote Pink, which is about an office worker in her early 20s who works as a call girl at night in order to help support her pet crocodile.
Okazaki also worked on the series Tokyo Girls Bravo, which was published in CUTIE, a mainstream Japanese fashion magazine aimed at teens.
[6][7] From 1995 to 1996, she worked on Helter Skelter, which features a beautiful model, Ririko, whose body underwent a total cosmetic surgery, and illustrates the accelerating derailment of her success.
[8] Helter Skelter was serialized in Shodensha's monthly Feel Young magazine at the time of writing and published later as a single tankōbon volume in 2003.
[4][12] Okazaki focused her work on contemporary urban life in Tokyo during the time that Japan witnessed an economic downturn in its transition from bubble economy of the 1980s to the Lost Decade of the 1990s.
[15] The main characters in some of her works such as Kuchibiru kara Sandanjuu and Tokyo Girls Bravo are bold, full of emotional expression and freewheeling, holding unconventional sets of values.
The protagonists, especially in her later work in the mid-1990s, on the other hand such as Yumiko in Pink and Ririko in Helter Skelter carry feelings of doubt and regret that overshadow their life choices.
[13] Throughout her work, she has made references to other manga, including Akimi Yoshida's Kisshō Tennyo and Yumiko Ōshima's Banana Bread Pudding.
[18] Okazaki is known for reappropriating the concept of girl and things considered girly, such as the color pink and nail polish, for young adult women.
[25] Together with other female artists who worked for hentai magazines such as Erica Sakurazawa, Shungicu Uchida and Yōko Kondo, she is sometimes referred to as "onna no ko H mangaka" ("women H cartoonists").
[26][27][28][29] Spies relates her work to third wave feminism for a variety of reasons: For reappropriating girl-ness, sexuality and sexuist language as well as for Okazaki's interest in punk and rock music.
In her manga, she has made references to musicians like The Slits and Kim Gordon from Sonic Youth, who is considered a pioneer of the Riot Grrrl movement.