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.

[12] On May 15, 2021, Tsutsugo was traded to the Los Angeles Dodgers in exchange for cash considerations or a player to be named later.

[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.

[25] On August 21, 2023, Tsutsugo signed a minor league contract with the San Francisco Giants organization.

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