He began his career as an onnagata (actor specializing in female roles) at the Nikkatsu studio.

When Japanese cinema began using actresses in the early 1920s, he switched to directing and worked for producers such as Shozo Makino, before becoming independent to make his best-known film, A Page of Madness (1926).

A silent film, Kinugasa released it with a new print and score to world acclaim.

He directed jidaigeki at the Shochiku studios, where he helped establish the career of Chōjirō Hayashi (later known as Kazuo Hasegawa).

After the war, he helmed big-budget costume productions for Daiei studios.