Kokeshi in other prefectures were made strictly following traditions under the apprenticeship system. Tsugaru kokeshi, originating from the Tsugaru region of Aomori Prefecture, have a history rooted in local artistry and cultural significance. The style was first developed around 1914 by Hidetaro Mori, who incorporated his unique artistic vision into the traditional kokeshi design. This innovation, known as the Nuruyu style, which emphasizes the curve of the doll, gained popularity around the Nuruyu Hot Spring and became an emblem of Kuroishi City. The Mori family's contributions, including the work of Hidetaro’s son, Shoichi Mori, further refined and preserved this distinctive style. Over time, Tsugaru kokeshi has become synonymous with the rich cultural identity of the region, blending historical craftsmanship with local motifs. 

Tsugaru kokeshi are distinguished by their round heads, cylindrical bodies, and hourglass-shaped designs, which set them apart from other regional kokeshi. These dolls often feature vibrant geometric patterns and motifs inspired by local cultures, such as the daruma figure and tree peony flower, the family crest of the Tsugaru clan. Notable features include the Ainu pattern drawn on the torso, the Daruma face with arched brows and a sharp glare, the wide base and curvy chest, and the extremely narrow waist. The okappa (bob-cut) hairstyle and the use of simple, earthy colors further enhance their aesthetic appeal. Today, the Tsugaru Kokeshi Doll Museum in Kuroishi City showcases these creations, offering insights into their craftsmanship and cultural significance while preserving the legacy of this traditional art form.