Many of Maruo's illustrations depict graphic sex and violence and are therefore referred to as contemporary muzan-e (a subset of Japanese ukiyo-e depicting violence or other atrocities.) Maruo himself featured in a 1988 book on the subject with fellow artist Kazuichi Hanawa entitled Bloody Ukiyo-e, presenting their own contemporary works alongside the traditional prints of Yoshitoshi and Yoshiiku.
Maruo's nightmarish manga fall into the Japanese category of "erotic grotesque". The stories often take place in the early years of Showa Era Japan. Maruo also has a fascination with human oddities, deformities, birth defects, and "circus freaks." Many such characters figure prominently in his stories and are sometimes the primary subjects of his illustrations. Two of his most recent works are adaptations of stories by Edogawa Rampo, such as "The Strange Tale of Panorama Island" and "The Caterpillar". An English translation of The Strange Tale of Panorama Island work was published by Last Gasp in July 2013.
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