Sayo Masuda has written the first full-length autobiography of a former hot-springs-resort geisha. Masuda was sent to work as a nursemaid at the age of six and then was sold to a geisha house at the age of twelve. In keeping with tradition, she first worked as a servant while training in the arts of dance, song, shamisen, and drum. In 1940, aged sixteen, she made her debut as a geisha.

Autobiography of a Geisha chronicles the harsh life in the geisha house from which Masuda and her "sisters" worked. They were routinely expected to engage in sex for payment, and Masuda's memoir contains a grim account of a geisha's slow death from untreated venereal disease. Upon completion of their indenture, geisha could be left with no means of making a living. Marriage sometimes meant rescue, but the best that most geisha could hope for was to become a man's mistress.

Masuda also tells of her life after leaving the geisha house, painting a vivid panorama of the grinding poverty of the rural poor in wartime Japan. As she eked out an existence on the margins of Japanese society, earning money in odd jobs and hard labor―even falling in with Korean gangsters―Masuda experienced first hand the anguish and the fortitude of prostitutes, gangster mistresses, black-market traders, and abandoned mothers struggling to survive in postwar Japan.