While studying at Atomi University, Okazaki made her debut in Cartoon Burikko, an experimental adult comic anthology primarily aimed at men. Okazaki would then turn her focus to women's issues. Focusing on the issues of contemporary young women, Okazaki never shied away from street culture, high fashion and drug use in her narratives. She would then take on her first a long-running series called Tokyo Girls Bravo; a rare comic to be published a fashion magazine. Okazaki has been in retirement since the end of the last century as she recovers from a life-threatening traffic accident.

Okazaki has received both the Japan Media Arts Award and the Osamu Tezuka Cultural Award for her work on Helter Skelter which was adapted into a motion picture in 2012 (now screening in the US in 2013).