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In 1941 she qualified as a nurse and volunteered to join the army. In October 1941 she sustained her first serious injury and concussion. After she recovered she was sent as a nurse to Military Hospital Train No. 122, where she served until May 1945. In 1943 she became a senior nurse and was given the rank junior lieutenant of medical service. In 1945 she became a lieutenant of medical service. In May 1945 she was sent to the Belomorsky Military District to take up the position of deputy head of the medical unit of a separate engineer battalion, from where she was demobilised in August 1945 with a 2nd category disability (almost complete loss of sight in her right eye and progressive blindness in the left eye, as a result of concussion). In 1971 she was declared a permanent 2nd category disabled person of the Great Patriotic War by the Moscow Professional Medical Expert Commission. 

From 1947 until 1953 she studied at the First Leningrad Medical Institute. She worked as a district doctor and paediatrician at a maternity hospital, taught children's diseases, was head of the teaching and practical unit of a medical institute in Moscow, and worked on assignment for the Soviet Ministry of Heath in Iraq. She was awarded the medal Otlichnik (Excellence) in Healthcare of the USSR.

She was involved in writing: she wrote articles for the magazines Neva and Yunost (Youth), and for the newspapers Literary Gazette and Medrabotnik (Medical Worker), and contributed to the collection Actors who died on the front of the Patriotic War. She was one of the authors of the book Vsevolod Bagritsky: diaries, letters and poems. She wrote for the Yunost programme on All-Union Radio, and worked as a freelance literary consultant on the literary section of Sovetskii Pisatel (Soviet Writer) publishers. She worked as editor in the Leningrad office of the Medgiz publishing house.

She joined the All-Union Leninist Young Communist League in 1938, throughout her service on the military medical train she was a Komsomol organiser and during her time in the institute she was a trade union leader. After the 22nd Congress she decided to join the CPSU; in 1964 she became a candidate and in 1965 she became a member of the CPSU. After the autumn of 1968 she began to have second thoughts and in 1972 she left the Communist Party because of her beliefs.

She had two children: a daughter Tatyana, born 1950, and a son Aleksei, born 1956. She was divorced from their father Ivan Semyonov in 1956. In January 1972 she married Andrei Sakharov, whom she had met in 1970 in Kaluga during the trial of Revolt Pimenov and Boris Vail.

During the 1960s to 1980s she initiated protests against the prosecutions of dissidents and was involved in disseminating accurate information about the trials.

In 1974 she helped set up the Foundation to Help the Children of Political Prisoners in the USSR.

In 1975 she represented Andrei Sakharov at the Nobel Prize ceremony in Oslo, at which he was awarded the Nobel Peace Prize.

In 1976 she became one of the founding members of the Public Group to Promote the Fulfillment of the Helsinki Accords in the USSR (Moscow Helsinki Group) and was an active member right up until the dissolution of the group in September 1982.

After Andrei Sakharov was exiled to Gorky in 1980 and until his arrest in May 1984 she acted as the risky, but most reliable, connection between Sakharov and the West. In August 1984 she was found guilty by the Gorky Regional Court under Article 190-1 of the Criminal Code of the RSFSR "because she had been systematically orally disseminating deliberately false fabrications defaming the Soviet state and social system, as well as producing written materials with the same content." She was sentenced to five years in exile in Gorky.

Upon her return to Moscow in 1987 together with Andrei Sakharov she played a direct role in the setting up of non-governmental associations and clubs such as Memorial and Moscow Tribune.

She was chair of the non-governmental international organisation The Public Commission to Preserve the Memory of Andrei Sakharov - the Andrei Sakharov Foundation.

She was a member of the Russian Presidential Human Rights Commission from the time it was founded until 28 December 1994. She resigned from the commission because she did not think she could work with a presidential administration that had unleashed the Russian-Chechen war.

She was a member of the Board of Directors of the International League for Human Rights and attended UN human rights conferences and sessions of the UN Human Rights Commission.

She received honorary doctorates in law from a number of American and European universities, and prizes and awards from a number of human rights organisations, as well as one Russian one: from the International Press Centre and Club Moscow — the For Press Freedom award in 1993.

She is the author of the book Postscript. A Book About Exile in Gorky (1988, published in several languages, including Russian – Moscow, Interbook, 1991), The Bell Tolls... a Year Without Andrei Sakharov (Moscow, PIK, 1991), Mothers & Daughters (1991, published in several languages, including Russian – Moscow, 1994, the publishing group Progress), Random Notes Towards a Genealogy of Andrei Sakharov (Moscow, Human Rights publishers, 1996).

She is the author of many articles published in the Russian and international press. She was never a member of any political party and only ever expressed her own views.