Competing in three Winter Olympics, she won the gold medal in the women's singles event in 2002 and 2006.

Otto finished in the top three of the Luge World Cup standings every year from 1999 to 2006, winning the overall title four times (1994-5, 1999–2000, 2002–3, 2003–4).

She retired from the sport on 12 January 2007, partly in order to have children and partly because of a crash at Königssee, Germany, the previous week and witnessing another crash, by Russia's Albert Demtschenko at Oberhof, that same week.

A retirement ceremony for Otto took place prior to the start of the women's singles event at the 2008 FIL World Luge Championships in Oberhof, Germany on 25 January.

Otto was one of the torch bearers for the 2004 Summer Olympics in Athens, Greece, as it traveled through Berlin, Germany.