[3] Because she was the author of works that impacted Japanese art during the Azuchi-Momoyama and Edo period, and served several prominent figures, Otsū was proclaimed one of the leading female calligraphers of premodern Japan.

In the capital, she studied arts, including waka composition with the nobleman Kujō Tanemichi (1507–1594) and was subsequently welcomed into aristocratic and high-ranking military circles.

During her life, she was said to have served Fujiwara no Haruko (Emperor Go-Yōzei's mother), Oda Nobunaga, Toyotomi Hideyoshi, Kodai-in (Nene), Yodo-dono.

Some accounts declare that she served in the retinue of Tokugawa Masako, the chief consort of Emperor Go-Mizunoo and mother of Empress Meishō.

Her style of calligraphy marked by ornamental decorations became a great inspiration for women of the highest castes of the Edo period.