After college, Moshfegh moved to China, where she taught English and worked in a punk bar.[4]
In her mid-twenties, Moshfegh moved to New York City. She worked for Overlook Press, and then as an assistant for Jean Stein. After contracting cat-scratch fever, she left the city and earned an MFA from Brown University.[4] During those years, she supported herself by selling vintage clothing which she has described as mostly "tea dresses."[13]
In 2014, Fence Books published Moshfegh's novella McGlue. McGlue was the first recipient of the Fence Modern Prize in Prose.[14]
In August 2015, Penguin Press published Moshfegh's novel Eileen. It received positive reviews.[15][16] The book was shortlisted for the 2016 Man Booker Prize.[17] In the book, Eileen, the protagonist and narrator, describes a series of events that occurred years ago, when she was young and living in a Massachusetts town that she calls "X-ville." At the beginning of the novel, she is working as a secretary at a local juvenile prison while living with and caring for her abusive father, a retired police officer with alcoholism and paranoia. As the story continues, the dramatic situation that causes her to leave her life in X-ville is revealed.
On July 10, 2018, Penguin Press published Moshfegh's second novel, My Year of Rest and Relaxation. The book describes a young art history graduate living in New York City over 15 months from mid-June 2000.[19] Recently graduated from college and ambivalently mourning the recent deaths of her parents, she quits her job as a gallerist[19] and undertakes to sleep for a year with the assistance of sleeping pills and other medications prescribed by a disreputable psychiatrist.
Also in 2018, Moshfegh wrote a piece for Granta in which she describes an experience she had with a much older male writer when she was 17 years old.[20]
Moshfegh is a frequent contributor to the Paris Review and has published six stories in the journal since 2012.[21]
In August 2020, Vintage published Moshfegh's third novel, Death in Her Hands.[22] Moshfegh has called the book "a loneliness story."[11]
In June 2022, Penguin Press published Moshfegh's fourth novel, Lapvona, which follows Marek, the abused son of the town shepherd, along with other characters from the fictional, medieval fiefdom of Lapvona.[23]
Moshfegh has cited the poet and novelist Charles Bukowski as an influence on her work. Like Moshfegh, Bukowski created characters who were considered socially deprived and isolated.[26]
Livingstone, Josephine (January–February 2017). "Ordinary monsters : Ottessa Moshfegh plots twisted fairy tales for an age of alienation". The New Republic. 248 (1–2): 59–60.