Akimov's design career began in 1922. He worked chiefly with Russian dramas, in which he combined cinematic with theatrical methods. His notorious version of Hamlet, his first venture as a producer, caused vehement reaction and was eventually withdrawn from distribution. From 1935 to 1949 and after 1955, Akimov was chief producer of the Leningrad Comedy Theatre. He also became professor and head of the faculty for design and production at the Leningrad Theatrical Institute from 1960.