When Reddy passed the Matriculation exam she applied for admission to Maharaja's College but her application was not welcomed by the Principal or the parents of other students. Her gender was a factor as was her background. The Principal thought she might "demoralize" the male students. The somewhat enlightened Maharaja of Pudukottai ignored these objections, admitted her to the college, and gave her a scholarship. Her father suggested that she can become a school teacher but she had higher aspirations. She entered Madras Medical College, completed her studies in 1912, and became House Surgeon in the Government Hospital for Women and Children in Chennai. She later married Sundara Reddy with the proviso that he promised to "always respect me as an equal and never cross my wishes." In 1914, when she was twenty-eight years of age, they married in accordance with the 1872 Native Marriage Act. During her college years, Muthulakshmi met Sarojini Naidu and began to attend women's meetings. She found women who shared her concerns and addressed them in terms of women's rights. The two great personalities who influenced her life were Mahatma Gandhi and Annie Besant. They persuaded her to devote herself to uplifting women and children. She worked for women's emancipation at a time when women were confined in the four walls of their room. She went to England for higher studies and she gave up her rewarding practice in medicine in response to a request from the Women's Indian Association (WIA) to enter the Madras Legislative Council. She was elected unanimously as its deputy president. She led the agitation for the municipal and legislative franchise for women. She was concerned about the orphans, especially girls. She arranged for them free boarding and lodging and started the Avvai Home in Chennai. Reddy was the author of numerous social reforms. Her book "My Experience as a Legislator" records her service. She passed a resolution to establish a special hospital for women and children. The government accepted her suggestion and opened a children's section in the maternity hospital. She recommended systematic medical inspection of students in all schools and colleges, run by municipalities as well as other local bodies. Kasturba Hospital at Triplicane is a monument to her efforts. She was the president of the All-India Women's Conference. She passed the bill for the suppression of brothels and immoral trafficking in women and children. A home for girls and women was opened through her efforts to provide shelter to those rescued from brothels.