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In 1965, he debuted under the stage name "Masaru Matsuyama", but did not achieve commercial success. Although he changed his stage name to "Eiichi Ichijō" in 1967 and then "Ken Mitani" in 1969, there was no change. In 1971, he changed his stage name to "Hiroshi Itsuki" and was given the song "Yokohama Tasogare" (よこはま・たそがれ?) by Masaaki Hirao. Written by lyricist Yoko Yamaguchi, "Yokohama Tasogare" reached the top of the Oricon weekly single chart.
His 2006 single "Takasebune" debuted at number 9 on the Oricon charts, becoming his first Top 10 single in 22 years since his 1984 single "Nagaragawa Enka". In 2008, he was featured in Morning Musume's Cover You album. He sang "Izakaya" with Ai Takahashi. Also in 2008, he collaborated with the girl group Cute, letting them record the song "Edo no Temari Uta", he himself was planning to include in his end-of-year album. Cute's producer Tsunku liked the song and thought that if performed by girls the enka lyrics will sound like "a modern fairytale". In what was called a collaboration by Tsunku and a rivalry between two performers by Sankei Sports, they both released the song as CD singles, Cute on July 30, and Itsuki as his 132nd single on October 22. Cute's version, entitled "Edo no Temari Uta II", was nominated for the main Japan Record Award of 2008, which also meant receiving a Gold Award from the Japan Composer's Association.