He began his career as Akshun (pronounced Action) recording solo for Lil' Troy's Short Stop Records, a local label in Houston. After releasing the 12" single "Scarface", he would go on to sign with Rap-A-Lot Records and join a group who were collectively known as Geto Boys replacing one member who left, and released the group's second album Grip It! On That Other Level (1989), a highly successful album that garnered the group a large fanbase, in spite of their violent lyrics keeping them from radio and MTV. He took his stage name from the 1983 film Scarface.
In 1992, Scarface appeared (along with Ice Cube and Bushwick Bill) on the Kool G Rap & DJ Polo album: Live and Let Die.
The album Mr. Scarface Is Back was a success, and Scarface's popularity soon overshadowed the other Geto Boys. Scarface remained in the group while releasing a series of solo albums that kept him in the public view with increasing sales, making him the only Geto Boys member that has always remained with the group since the group personnel was revamped in 1989. This peaked with The Diary and The Last of a Dying Breed, which received overwhelmingly positive reviews and sales, and earned him Lyricist of the Year at the 2001 Source Awards.
In 2002, he released The Fix, the follow-up to The Last of a Dying Breed and returned to the studio with the Geto Boys for their album, The Foundation. He was also featured on The Biggie Duets alongside Big Gee and Akon. He guested on Ray Cash's debut single "Bumpin' My Music".
In addition to his career as a rapper, Scarface has also been the coordinator and president of Def Jam South since 2000, where he has fostered the career of popular rapper Ludacris, whom he originally signed to the label.
Scarface has appeared on Freeway's album Free at Last and on Beanie Sigel's album, The Solution. Scarface is currently planning production; he has produced three tracks on UGK's Underground Kingz including "Life in 2009," "Still Ridin' Dirty," and "Candy."
Some of Scarface's early music videos ("A Minute to Pray and a Second to Die") featured community activist Quanell X in supporting roles.
In 2008, Scarface collaborated with rapper Tech N9ne on his album Killer on the song "Pillow Talkin'".
Despite limited commercial appeal, he remains out of the norm and uniquely popular amongst those in the industry, and has been described as "your favorite rapper's favorite rapper".On August 6, 2009 Scarface performed at the 2009 Gathering of the Juggalos. In 2005, comedian Chris Rock praised Scarface as one of the best three rappers of all time on his list of the Top-25 Hip-Hop Albums ever. "
On June 30, 2010, Scarface announced that he is working on a new album entitled The Habit which will include features from John Legend and Drake that is scheduled for release this Fall. For one production on the album, Scarface co-hosted a worldwide producer showcase with iStandard from which thousands of producers were considered and after a selection of the top 8, Alex Kresovich was named winner. The album is also said to feature production from Eminem. In February 2011, news came that he has been held in jail without bail since September 2010 for failure to pay child support in four different cases. As of August 2011, Scarface has been released from jail and is currently working on a new solo album. In 2012, Scarface collaborated with Ice Cube on an Insane Clown Posse remix called "Chris Benoit" on The Mighty Death Pop!'s bonus album Mike E. Clark's Extra Pop Emporium.