Tsuzaki took the Officials' Oath at the Opening Ceremony of the 2020 Summer Olympics in Tokyo, Japan, becoming the first female water polo referee to be given the honour. During the Games she acted as referee in the women's water polo tournament. On 24 July 2021, Tsuzaki and Ursula Wengenroth of Switzerland officiated the match between South Africa and Spain, which is the first time that two women had officiated an Olympic water polo match.