Ushijima was born in Kagoshima city, where his father had been a samurai in the service of Satsuma Domain and later a career officer in the early Imperial Japanese Army.

[citation needed] In April 1919, Ushijima served as commander of the 4th Guards Regiment and became an instructor at the Army Infantry School in August 1920.

Although greatly outnumbered, Ushijima fought a series of battles from August 30 through September 13, breaking through the Chinese lines, and reaching the outskirts of Shijiazhuang by October 14, albeit with heavy casualties.

The IJA 36th Brigade then assisted in breaking the deadlock in Shanghai and captured a large number of Chinese soldiers and their weapons fleeing the city for Nanjing.

However, Ushijima was reinstated instead as commandant of the Imperial Japanese Army Academy, largely at the recommendation of Kenji Doihara and Otozō Yamada, who shared his misgivings about the Pacific War.

[citation needed] Ushijima's warnings were prophetic, and despite his stated desire to remain an educator, he was ordered to take command of the newly formed 120,000 man 32nd Army, charged with the defense of the Ryukyu Islands against American invasion.

However, he was less successful in his efforts to evacuate the remainder of the civilian population to the largely uninhabited northern half of the island due to lack of food supplies, malaria, and the need to conscript many able-bodied civilians to assist in the construction of trenches, bunkers and other defensive works, including his command headquarters in a network of tunnels under Shuri Castle in Naha.

[citation needed] Ushijima led a skillful defense of the island based on a defense in depth as planned by his chief of staff, Colonel Hiromichi Yahara; however, he was constantly undermined by insubordination by his second in command, General Isamu Cho, who was pursuing a more aggressive policy encouraged by the Army General Staff in Tokyo for mass attacks against the invading American forces.

[citation needed] Ushijima refused a plea via leaflets dropped on Japanese positions on the 11 June from the American General Simon Bolivar Buckner Jr. to surrender.

[3] By middle June the 32nd Army was effectively reduced to occupying two strongpoints, one beneath Kunishi Ridge and the other, the command headquarters inside Hill 89.

You will live for eternity.”[3] Ushijima and Cho had decided to commit Seppuku (ritual suicide) and on the night of their planned departure held a banquet in the cave housing the command post with a large meal prepared by Ushijima's cook, Tetsuo Nakamutam, which was complemented with plenty of sake and Cho's remaining stock of captured Black & White Scotch whisky.

[3] Later in the early hours of 22 June the staff in the command post lined up to pay their respects to Ushijima who was attired in his full dress uniform and Cho who wore a white kimono.

Handed a knife by an aide Ushijima shouted and made a deep vertical cut in his bared abdomen before Captain Sakaguchi (who was regarded as a master swordsman) decapitated him with his sword.

Yahara had asked Ushijima for permission to commit suicide, but the general refused his request, saying, "If you die there will be no one left who knows the truth about the battle of Okinawa.

"[7] Ushijima was described as a humane man who discouraged his senior officers from striking his subordinates and who disliked displays of anger because he considered it a base emotion.