He has previously played in Major League Baseball (MLB) for the Tampa Bay Rays, Los Angeles Dodgers, and Pittsburgh Pirates.

Tsutsugo was selected to the next three NPB All-Star Games, winning the Kantosho (敢闘選手賞) or "Fighting Spirit Award" in all three appearances.

After the 2019 season, on November 15, 2019, BayStars announced it was allowing Tsutsugo to enter the posting system to play in Major League Baseball (MLB).

[8] On December 16, 2019, Tsutsugo signed a two-year, $12 million contract with the Tampa Bay Rays of Major League Baseball.

[10] On July 24, 2020, Tsutsugo was the starting third baseman, making his MLB debut on Opening Day against the Toronto Blue Jays.

[17] On August 16, 2021, he signed a major league contract with the Pittsburgh Pirates, and played his first game with the team on the same day.

On August 15, 2022, Tsutsugo signed a minor league deal with the Toronto Blue Jays organization.

[23] On August 1, 2023, Tsutsugo signed with the Staten Island FerryHawks of the Atlantic League of Professional Baseball.

[26][27] He hit .311 in 13 games for the Double–A Richmond Flying Squirrels and finished the year with the Triple–A Sacramento River Cats.

[30] On April 16, 2024, Tsutsugo signed a contract to return to the old team Yokohama DeNA BayStars of Nippon Professional Baseball.