Wagner was an aerialist and contortionist, working in numerous traveling circuses. She met Gus Wagner—a tattoo artist who described himself as "the most artistically marked up man in America" while traveling with circuses and sideshows—at the Louisiana Purchase Exposition (World's Fair) in 1904, where she was working as an aerialist. She exchanged a romantic date with him for a lesson in tattooing, and several years later they were married. Together they had a daughter, Lotteva, who started tattooing at the age of nine and went on to become a tattoo artist herself.

As an apprentice of her husband, Wagner learned how to give traditional "hand-poked" tattoos—despite the invention of the tattoo machine—and became a tattooist herself. Together, the Wagners were two of the last tattoo artists to work by hand, without the aid of modern tattoo machines. Maud Wagner was the United States' first known female tattoo artist.

After leaving the circus, Maud and Gus Wagner traveled around the United States, working both as tattoo artists and "tattooed attractions" in vaudeville houses, county fairs and amusement arcades. They are credited with bringing tattoo artistry inland, away from the coastal cities and towns where the practice had started.

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