In 1909 he was diagnosed with tuberculosis, yet this threat of impending death seemed to have energized Powys, for he devoted himself from then on to his writing. He published his first book in 1916, a collaborative collection of stories with his brother John, called Confessions of Two Brothers, but his first solely written book, Ebony and Ivory, was not published until 1923. Between 1920-25, having moved to the United States, six more books were published and it was here he finally achieved fame.

In 1936 Powys’ health severely deteriorated and he left for the sanatorium in Davos, Switzerland, in which he died in 1939. Love and Death, considered Llewelyn Powys' best work, was published posthumously, in 1939. As is characteristic of Powys' work, Love and Death presents in microcosm all the elements of Llewelyn Powys's unusual combination of fictionalized, autobiography, memoir of desire rather than exact fact, and personal essay with so thin a veneer of objectivity that the self-centered subjectivity causes constant tension within the work and in the perception of the reader.