Mutoh grew up in Tokyo, where his family operated a long-standing seafood wholesale business called Hotei Tora in Tsukiji fish market, and he stood to inherit it as the sixth-generation owner. Instead he chose motorsport, beginning karting at age twelve in 1995 and winning the East Series of the Karting Kanto Championship in 1997. The day after graduating junior high school in 1998, he moved to England to pursue a racing career, making his competitive debut in 1999 in the Formula Vauxhall Junior Winter Series.
His British campaigns included British Formula Ford in both 2000 and 2001, where he twice finished ninth in the series and placed third in the Formula Ford European Championship in 2001. Returning to Asia short of funds, he borrowed money from his grandfather — the fourth-generation Hotei Tora owner — against a written IOU to continue.
Back in Asia in 2002, Mutoh raced in Asian Formula 2000 and Formula Dream, finishing second in the Formula Dream series as a rookie before winning the championship outright in 2003. A move into Japan Formula 3 followed: ninth in 2004, third in 2005. In 2006 he joined Nakajima Racing for campaigns in both Formula Nippon and Super GT 500-class, taking his first Super GT victory in the season's final round at Fuji Speedway from pole position and recording the fastest lap in the seventh Formula Nippon round at Sportsland SUGO.
Autobacs Racing Team Aguri (ARTA) signed Mutoh to contest the 2007 Indy Pro Series in a car prepared by Panther Racing. He won from pole at the Indianapolis Motor Speedway road course during the United States Grand Prix weekend and added another win at Kentucky Speedway, finishing second in the championship and earning Rookie of the Year honors. In September he made a one-off IndyCar Series debut at Chicagoland Speedway for Panther Racing, finishing eighth and posting the fastest lap of the race. The performance drew the attention of Andretti Green Racing, which on October 31, 2007 announced Mutoh would replace the departing 2007 IndyCar champion Dario Franchitti in the team's full-time No. 27 entry for 2008.
Mutoh's 2008 season opened at Homestead-Miami Speedway. At the Indianapolis 500 he qualified ninth, the highest-qualifying rookie in the field, and finished seventh — the second-best result by a Japanese driver in the race's history to that point and the highest finish among that year's rookies, though the Rookie of the Year award went to Ryan Hunter-Reay on points. At Iowa Speedway in June, Mutoh finished second to Dan Wheldon, establishing a new benchmark for the best IndyCar result by a Japanese driver, surpassing Tora Takagi's third place at Texas Motor Speedway in 2003. He ended 2008 tenth in the championship and earned both the series Rookie of the Year and Fastest Rookie of the Year distinctions.
In 2009 mechanical trouble hampered the early season. At Indianapolis he qualified sixteenth and finished tenth. His best result came again at Iowa — third place — giving him back-to-back podiums at the circuit. He led 74 laps at Richmond International Raceway, his first laps led in the IndyCar Series, and finished fourth. Two fifth-place road-course finishes at Mid-Ohio and Sonoma rounded out a season that closed eleventh in points, one point outside the top ten.
For 2010 Mutoh moved to Newman/Haas Racing. At Kansas Speedway he qualified a season-best fourth and was running in podium contention when a restart collision with Takuma Sato ended both drivers' races with fourteen laps remaining. At the Indianapolis 500 he again qualified ninth but retired with handling issues. He finished eighteenth in the final standings with a best result of twelfth, and did not return to IndyCar full-time after the season ended.
Mutoh returned to Super GT in 2011 for Aguri Suzuki Honda alongside Takashi Kobayashi. He also made a one-off appearance at the 2011 Indy Japan: The Final race at Twin Ring Motegi for Sam Schmidt Motorsports, finishing nineteenth. He continued competing in Super GT in subsequent years and last raced in the 2022 Super GT season for Autobacs Racing Team Aguri, the team that had launched his American career fifteen years earlier.
Mutoh's IndyCar tenure is remembered for consistently raising the bar for Japanese drivers on American ovals and road courses. His second-place finish at Iowa in 2008 stood as the best IndyCar result for a Japanese driver, and his back-to-back Rookie of the Year honors — in Indy Pro in 2007 and IndyCar in 2008 — reflected a rapid and successful adaptation to oval racing. His career traced an unusual arc from a Tokyo fish-market family through the British junior formulae, Japanese domestic championships, and a sustained North American campaign, before returning to close out his career in Japan.
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