She is the director and principal choreographer[2][4] of the high-tech[5] dance troupe Elevenplay, and also works with performers such as Perfume,[6] Sakura Gakuin,[7] and Babymetal.

[12] In order for her to become a theater director, Osato instructed her to move to New York to study stage production and improve her sensibility.

[23][24][25] In 2014, Elevenplay and Hatsune Miku performed as the opening acts of Lady Gaga's ArtRave: The Artpop Ball concert.

However, it was announced on 23 December 2020 that the committee had been disbanded due to the "simplifications" necessitated by the COVID-19 pandemic, which had also caused the event itself to be delayed to July 2021.

[35] In 2014, Mikiko choreographed and directed an advertising video for Isetan that won the Good Design Award.

For this performance, Mikiko created the storyboard and advised artist and frequent collaborator Daito Manabe of Rhizomatiks and others on lighting and camera work.

[42] She uses everyday gestures in her choreography and sometimes deploys advanced technology such as projectors, drones, LEDs, and moving semi-transparent screens.

[45] On choreographing the dance for heavy metal, scriptwriter and producer Chiaki J. Konaka remarked that Mikiko's influences included the signature blast beats and guitar solos of the genre.

[46] Perfume's choreography is influenced by science fiction imagery and emphasizes upper body and robot-like hand movements.

Gen Hoshino described the choreography as "magnifying the charm of the song and its ability to communicate to the listener many times over.