He made his debut at the age of 16 in the Kō Nakahira film Crazed Fruit in 1956. Tsugawa's family was heavily involved in the film industry since before his birth. Tsugawa attended school until dropping out of the Waseda University Graduate School to pursue acting alone.
Tsugawa recently debuted as a director under the pseudonym Makino Masahiko with his film Nezu no Ban. He chose this name because he is the nephew of the Japanese director Masahiro Makino, his mother's brother. Legend has it that Tsugawa was so awed by the director while watching him at work as a young child that he asked if he could use Makino as his last name should he ever be a director, because of the similarities of the first names.