B. Suresha began his career as a child actor in Ghatashraddha (1977), a film that won international acclaim. He later worked closely with Shankar Nag as an assistant director on projects such as Accident (1985) and Malgudi Days (1986). His early years were marked by contributions as a scriptwriter, notably collaborating with Ravichandran in 1993. He also directed television serials like Hosa Hejje (1991), Sadhane on Doordarshan, and Naaku Thanthi, which established him as a creative force in Kannada television.
Transitioning into film direction, he made his debut with Tapori and later directed acclaimed works such as Artha and Puttakkana Highway. In 2008, he returned to acting with Slum Bala, and in 2016, his film Devara Naadalli—based on a Times of India article—was released. He also launched the entertainment channel Rangoli in 2016. His film Uppina Kagada (2017) explored themes of identity and belonging. Over the years, Suresha has balanced roles as director, producer, actor, and writer, making him one of the most versatile contributors to Kannada cinema.