His works range from tales of ordinary life to dream-like surrealism, and often show his interest in traveling about Japan.
Since 1987, he has stopped producing comics, and has lived a quiet life with his son in Tokyo since his wife's death in 1999, occasionally cooperating with adaptations and reproductions of his past work.
The recession in post-World War II Japan, inspired Tsuge to create comics to the pay-libraries' editors in an attempt to solve his financial problems.
Being intensely shy, making dramatic pictures was one way to avoid meeting people and to earn money simultaneously.
[2] Tsuge began his cartooning career contributing to the kashibon rental comics market which flourished in the 1950s.
[3] The nihilistic stories, which Tsuge considers hackwork, were done in the gekiga style—dark, realistic comics with mature themes which first developed in Japan in the late 1950s and 1960s.
Screw Style (or Screwceremony)[7] (ねじ式, neji-shiki), Tsuge's most famous work, was published in Garo in 1967.
Said to have come from a dream Tsuge had while taking a rooftop nap, the twenty-three page work follows a youth who first appears wading out of the ocean.
[3] Laden with symbolic images of rural poverty, industry and the Pacific War,[7] his journey takes him through a village on a train moving backwards, and he finally has his arm mended by a gynecologist who attaches a valve to his severed artery.
[7] In February 1968, Tsuge became involved with the avant-garde actress and children's book illustrator Maki Fujiwara [ja].
His last published work of comics was "Parting" (離別, Ribetsu) in June 1987, in which the main character attempts suicide after a relationship breaks up.
In 1966, Tsuge suffered from another onset of depression and stopped drawing his own manga to be Shigeru Mizuki's assistant.
Under Mizuki's influence, Tsuge's later publications feature highly detailed backgrounds and his trademark cartoonish-characters.
Gilles Laborderie in Indy Magazine notes that Tsuge "tries to create a pace through careful narrative techniques rather than through grand dramatic events" and compares his style to Yoshihiro Tatsumi's.
[13] Holmberg later translated the following, all published by Drawn and Quarterly: Nejishiki,[14] Oba Electroplating Factory,[15] Red Flowers,[16] and The Swamp.
Drawn & Quarterly has announced that, beginning in April 2020, they will publish English translations of his complete works in seven volumes.
"The Woman Next Door") were translated as Nejishiki in 2018, El hombre sin talento in 2015, and La mujer de al lado in 2017 respectively, by Gallo Nero Ediciones.
In Portuguese, The Man Without Talent was translated as O Homem sem Talento in 2019 by the Brazilian publisher Veneta [pt].
[4] In his pre-Garo phase, Tsuge has been included among those considered to have made gekiga—dark, realistic comics with mature themes which first developed in Japan in the late 1950s and 1960s.