Her first public performance was at the age of fifteen. Her first recording was done by the Megaphone Record Company at the age of Fifteen. The famous poet Sarojini Naidu appreciated her singing during a concert that was organized in the aid of victims of the 1934 Nepal–Bihar earthquake.
Her most intoxicating composition was Deewana Banana Hai to Deewana Bana De. It contained a captivating effervescence maddening her listeners.
She had an endless reservoir of Ghazals as she developed a deep understanding of literary nuances of Ghazals by great Urdu poets like Ghalib, Jigar, Faiz Ahmad Faiz, Kaifi Azmi, Shakeel Badauni and Hasrat Jaipuri that were introduced to her by her husband Abbasi Sahib, who was a Barrister by profession.
She also acted in a few Hindi films She was signed by East India Film Company as a singing actor. Her first film was East India Film Company’s ‘Ek Din Ka Baadshah’ (1933). This was followed by ‘Nal Damyanti’ (1933), ‘Mumtaz Begum’ (1934), ‘Roop Kumari’ (1934), ‘Ameena’ (1934), ‘Jawani Ka Nasha’ (1935), ‘Naseeb Ka Chakkar’ (1936) etc.. In all these films, she sang all her songs herself.
After staying at Bombay for a few years she came back to Lucknow, where she was approached by the famous producer-director Mehboob Khan, to act in Roti which was released in 1942 and whose music was composed by the maestro Anil Biswas.
Begum Akhtar was India’s most refined Ghazal performer, who was honored by the titles like; Mallika-e-Ghazal (Queen of Ghazals). She bestowed an inimitable style of singing and performed mostly self-composed masterpieces like “Woh Jo Humme Tumme Quarar Tha” and the Dadras like “Hamri Atarya Pe Aao Sanwarya Deikha Deikhi Balam Hui Jaey” and “Cha Rahi Kari Ghata, Jiya Mora Laharaye Hai” and many more.
Begum Akhtar was persuaded by Madan Mohan, a famous music director to sing in two movies "Daana Paani" (1953) and "Ehsaan" (1954). The songs "Aye Ishq Mujhe Aur to Kuch Yaad" and "Hamein Dil Mein Basa Bhi Lo" were absolutely melodious and were liked by one and all. Her last movie stint was that of a classical singer in Satyajit Ray's film "Jalsa Ghar".
Begum Akhtar performed last in a concert in Ahmedabad. That day she felt that her voice was not up to the mark and raised her pitch. This put much stress on her and her health deteriorated. The situation became critical and she had to be rushed to the hospital. She breathed her last on 30th October 1974,