Focusing on girls that were nine to seventeen years of age, Livingston made it her life's work to free thousands of girls and women from sexual slavery beginning on March 4, 1903 or about 1904.
Her modus operandi was to follow men that were sexual slavers, figure out what females were held captive, make friends with them, and encourage them to escape.
She looked for enslaved girls in opium dens, dance halls, and bars, particularly in New York City's Chinatown and the Brooklyn Navy Yard.
Sometimes she ventured out of the city to Boston, Newark, Bridgeport, New Haven, and Chicago.
In 1907, there were 300 girls younger than 18 in Chinatown that were sex workers, out of a total of 800 white slaves.
Six years later, she could not find any girls under age 18 there.

She had a masculine looking face and she her hair cut short and wore men's clothing when she went in search of girls to rescue—so that she could blend in at dance calls and other night spots.

After she was able to free girls and young women, she offered rehabilitation, and ministered to them in accordance with her Christian faith.
Called the "Angel of Chinatown", she considered herself a missionary and an independent social worker.
She saved an eight-year-old girl who had been kidnapped and taken to Philadelphia, after being asked by her father to find his daughter.
There were times when bravery and quick thinking helped her rescue girls, like the time that she saved a girl who was being kidnapped by three men.
She motioned that she had a gun in her pocket and waited for the police, who arrested the men.
She went on high-speed chases in taxis to save girls.
When she rescued girls, she took them to her apartment, rather than the police or the children's society, and contacted the girls' families.
She was aware of the fact that it was a difficult process to transition back into a family, so she did not believe in rushing girls back to their parents' homes.
Livingston described her brand of missionary work:
I don't go in to visit these girls and give them a tract and say 'God bless you', and invite them around to take tea with me.
That's not my kind of work.
There are some girls that it might hard to help, but there are some little, fresh young things that have just been brought to Chinatown, and that you can sometimes reach in time to save them.
Sometimes you can get there before the harm is done.

— Rose Livingston, speaking at the Metropolitan Temple, 1912
By 1934, with over 30 years of experience, Livingston rescued 800, 4,000, or 5,000 girls or young women.
Of the girls that she rescued, only two returned to life as a sex worker.
If the girl had a baby, in her experience, not one of the girls' families took the baby into the family.
Many of the girls she rescued looked on her as a mother, and brought potential husbands to her for approval.
The League of Nations identified her as a noted figure in the fight against sexual slavery around the world.
She found that there was a world-wide network of trafficking sexual slaves.
In a report by the League,
Miss Livingston sets forth the diabolical tactics of white slave rings in this country as she has seen them.
She suggests a remedy and sounds a warning to mothers and fathers.

— League of Nations
She offered solutions to the sexual slavery problem, particularly regarding girls and young women.
She asked all women to be more understanding of children, so that they did not want to run away from home.
She suggested that cities hire plain-clothed police women to patrol vice-ridden districts to prevent girls from being led into slavery.
She asked parents to talk to their daughters about the danger of being taken, without terrorizing them.
Livingston stated that she believed that this would dramatically reduce the likelihood of girls being kidnapped by avoiding the first false, reckless step—like getting into the car of a stranger.
Focusing on girls that were nine to seventeen years of age, Livingston made it her life's work to free thousands of girls and women from sexual slavery beginning on March 4, 1903 or about 1904. Her modus operandi was to follow men that were sexual slavers, figure out what females were held captive, make friends with them, and encourage them to escape. She looked for enslaved girls in opium dens, dance halls, and bars, particularly in New York City's Chinatown and the Brooklyn Navy Yard. Sometimes she ventured out of the city to Boston, Newark, Bridgeport, New Haven, and Chicago. In 1907, there were 300 girls younger than 18 in Chinatown that were sex workers, out of a total of 800 white slaves. Six years later, she could not find any girls under age 18 there.
She had a masculine looking face and she her hair cut short and wore men's clothing when she went in search of girls to rescue—so that she could blend in at dance calls and other night spots.
After she was able to free girls and young women, she offered rehabilitation, and ministered to them in accordance with her Christian faith. Called the "Angel of Chinatown", she considered herself a missionary and an independent social worker. She saved an eight-year-old girl who had been kidnapped and taken to Philadelphia, after being asked by her father to find his daughter. There were times when bravery and quick thinking helped her rescue girls, like the time that she saved a girl who was being kidnapped by three men. She motioned that she had a gun in her pocket and waited for the police, who arrested the men. She went on high-speed chases in taxis to save girls. When she rescued girls, she took them to her apartment, rather than the police or the children's society, and contacted the girls' families. She was aware of the fact that it was a difficult process to transition back into a family, so she did not believe in rushing girls back to their parents' homes. Livingston described her brand of missionary work:
I don't go in to visit these girls and give them a tract and say 'God bless you', and invite them around to take tea with me. That's not my kind of work. There are some girls that it might hard to help, but there are some little, fresh young things that have just been brought to Chinatown, and that you can sometimes reach in time to save them. Sometimes you can get there before the harm is done.
— Rose Livingston, speaking at the Metropolitan Temple, 1912
By 1934, with over 30 years of experience, Livingston rescued 800, 4,000, or 5,000 girls or young women. Of the girls that she rescued, only two returned to life as a sex worker. If the girl had a baby, in her experience, not one of the girls' families took the baby into the family. Many of the girls she rescued looked on her as a mother, and brought potential husbands to her for approval. The League of Nations identified her as a noted figure in the fight against sexual slavery around the world. She found that there was a world-wide network of trafficking sexual slaves. In a report by the League,
Miss Livingston sets forth the diabolical tactics of white slave rings in this country as she has seen them. She suggests a remedy and sounds a warning to mothers and fathers.
— League of Nations
She offered solutions to the sexual slavery problem, particularly regarding girls and young women. She asked all women to be more understanding of children, so that they did not want to run away from home. She suggested that cities hire plain-clothed police women to patrol vice-ridden districts to prevent girls from being led into slavery. She asked parents to talk to their daughters about the danger of being taken, without terrorizing them. Livingston stated that she believed that this would dramatically reduce the likelihood of girls being kidnapped by avoiding the first false, reckless step—like getting into the car of a stranger.
Rose Livingston