Berghaus was born in Dresden and studied Expressionist dance and Dance direction with Gret Palucca there and was an advanced student at the German Academy of Arts in Berlin, at least part of the time under Walter Felsenstein - associated with the Komische Oper East Berlin he founded - along with his two other first leading protégés, Götz Friedrich and Joachim Herz (1924–2010). All three would mark a departure from Felsenstein's insistence on textual accuracy in favor of Brechtian interpretation, but were in part inspired by also his insistence on maintaining an even balance between the musical and dramatic aspects of an opera being staged. From 1951 to 1964, Berghaus worked as choreographer on many stages, including the Deutsches Theater Berlin, the Deutsche Staatsoper Berlin and the Berliner Ensemble. Her work as a director began with the Die Verurteilung des Lukullus of Paul Dessau and Bertolt Brecht, at the Deutsche Staatsoper, in 1960. Brecht's work would represent a major part of Berghaus's career. She became well known for her choreography of the slaughter scenes in Brecht's adaptation of Shakespeare's Coriolanus at the Berliner Ensemble in 1964.
In 1954, Berghaus married the composer Paul Dessau, whose works for the theater she directed. Her association with the Berliner Ensemble culminated with her directorship of that theater until 1977.
From 1980 to 1987, Berghaus worked at the Frankfurt Opera. Her notable productions there included a 1980 Die Zauberflöte of Wolfgang Amadeus Mozart, 1981 Mozart's Die Entführung aus dem Serail, 1982 Les Troyens of Hector Berlioz (designs by Hans-Dieter Schaal), Věc Makropulos of Janáček and Richard Wagner's Parsifal and 1985–87 Der Ring des Nibelungen. In 1992, she returned to Frankfurt to direct Der Rosenkavalier. Her work at the Frankfurt Opera also marked an important collaboration there with Michael Gielen as music director. Leading protégés of both would from a similarly strong collaboration in Hamburg in the late 1990s and first half of the past decade - in Peter Konwitschny and Ingo Metzmacher. The indirect influence of Berghaus's unique intellectual grasp of inculcating choreography in her staging of opera can (perhaps) be also felt in productions by Harry Kupfer, including of his Ring at Bayreuth and at Staatsoper Berlin and also of Jurgen Flimm - worthy of note his production of Otello at Staatsoper Berlin - also conducted by Daniel Barenboim. Her most notable protégés are today reckoned to be Konwitschny and the American producer David Alden.
In 1985, in Prague, she directed Alban Berg's Wozzeck and, in Dresden, Die Weise von Liebe und Tod des Cornets Christoph Rilke by Siegfried Matthus. In 1986, she debuted with the Wiener Staatsoper with the choreography of Hans Werner Henze's Orpheus. In 1988 she staged Arnold Schoenbergs "Moses und Aaron" at Staatsoper Berlin, as conducted by Friedrich Goldmann. With a key modernist opera by an Austrian-American composer, staged in East Germany's leading opera house, the event has been considered a major breakthrough in overcoming the state dogma of socialist realism. In Brussels, Berghaus directed Berg's Lulu in 1988, and in that same year, Schubert's Fierrabras. In Zürich, her productions included Weber's Der Freischütz and Wagner's Der fliegende Holländer. Her final operatic production was Johann Strauss's Die Fledermaus, produced in Leipzig, in 1995. Performed and published posthumously, the only representation of Ruth Berghaus on film is Weber's Der Freischütz, a Zurich revival of 1999, as conducted by Nikolaus Harnoncourt.
In 1989, she began a theatrical series of what she called 'related texts', with a production of Büchner's Danton's Death and in 1991 a production of Brecht's In the Jungle at the Thalia Theater in Hamburg.
- Meech, Tony. 1994. "Brecht's Early Plays." In Thomson and Sacks (1994, 43-55).
- Thomson, Peter and Glendyr Sacks, eds. 1994. The Cambridge Companion to Brecht. Cambridge Companions to Literature Ser. Cambridge: Cambridge University Press. ISBN 0-521-41446-6.
- Meech (1994, 54).