Sakai trained under Jaguar Yokota,[2] and made her debut on April 20, 1997, with the Yoshimoto Ladies Pro Wrestling promotion, facing Yabushita at the Korakuen Hall in Tokyo.

While in Japan, Sakai faced several prominent male Japanese wrestlers, including Dick Togo, The Great Sasuke and Jinsei Shinzaki.

On April 17, 2005, Sakai organised "WE LOVE SABU", a pair of shows held at the Differ Ariake Arena in Tokyo.

In 2012, Sakai joined Kurt Pellegrino's Mixed Martial Arts Academy in Belmar, NJ to better her BJJ and pursue her MMA career.

[24][25][26][27] Since 2018, Sakai took part in the tournament to crown the inaugural Women of Honor World champion, where she won in the first round (at ROH 16th Anniversary Show) against Hana Kimura.

[31] At Final Battle 2018 Sakai lost the championship to Klein in a Four Corner Survival match which also involved Karen Q and Rayne.

[33] On January 11, 2020, at the Saturday Night at Center Stage, Sakai teamed with Nicole Savoy when they faced The Allure (Angelina Love and Mandy Leon) in a losing effort.

[35] With ROH returning after the COVID-19 pandemic, Sakai made had her first match over a year on May 5, 2021, where she defeated Vita VonStarr, working as a face again.

[36][37] On July 7, Sakai received a "Ticket to Gold" to compete at a tournament to crown the inaugural ROH Women's World Champion.