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Koizumi had singles reach the Top Ten for 12 consecutive years between 1983 and 1994, a female solo artist record, until this was broken by Namie Amuro. In the 1990s, she released a few dance remixes on vinyl only under the Koizumix Production moniker. She has worked with Yoko Kanno who composed the music for Koizumi's 1996 album, Otoko no Ko Onna no Ko. She had her first hit single in 18 years when her version of the song "Shiosai no Memorī" from the 2013 NHKmorning television dramaAmachan, in which Koizumi also acted, reached number 2 on the Oricon Singles Chart.
As an actress, she played in numerous dramas and movies; most notably, she was cast in two of the most successful movies in Japan ever: as the serial killer in Bayside Shakedown: The Movie (1998) and as the witch in Onmyoji (2001).