Bessie Emery Head was born in Pietermaritzburg, South Africa, the child of a wealthy white South African woman and a black servant when interracial relationships were illegal in South Africa. It was claimed that her mother was mentally ill so that she could be sent to a quiet location to then give birth to Bessie without the neighbors knowing. However, the exact circumstances are disputed, and some of Bessie Head's comments, though often quoted as straight autobiography, are in fact from fictionalized settings.

In the 1950s and 60s she was a teacher, then a journalist for Drum, a South African magazine. In 1964 she moved to Botswana (then still the Bechuanaland Protectorate) as a refugee, having been peripherally involved with Pan-African politics. It would take 15 years for Head to obtain Botswana citizenship. Head settled in Serowe, the largest of Botswana's "villages" (i.e. traditional settlements as opposed to settler towns). Serowe was famous both for its historical importance, as capital of the Bamangwato people, and for the experimental Swaneng school of Patrick van Rensburg. The deposed chief of the Bamangwato, Seretse Khama, was soon to become the first President of independent Botswana.

Her early death in 1986 (aged 49) from hepatitis came just at the point where she was starting to achieve recognition as a writer and was no longer so desperately poor.

Most of Bessie Head's important works are set in Serowe, in particular the three novels When Rain Clouds Gather, Maru, and A Question of Power. One of her best works is When Rain Clouds Gather, where she writes about a troubled young man called Makhaya who runs away from his birth place, South Africa, to become a refugee in a little village called Golema Mmidi, in the heart of Botswana. Here he is faced with many challenging tasks. One of which is the fact that Chief Matenge does not allow his presence in the village. He meets a white man named Gilbert and starts a whole new journey into the unknown.

She also published a number of short stories, including the collection The Collector of Treasures. She published a book on the history of Serowe, the village she settled in, called Serowe: Village of the Rain Wind. Her last novel, A Bewitched Crossroad, is historical set in nineteenth-century Botswana.

Bessie Head's work , which emphasised the value of ordinary life and humble people, was more in touch with an earlier trend in African writing than many recent writers who have made overtly political comments. Her writing has endured nonetheless. Religious ideas feature prominently at times, as in the work A Question of Power. It is interesting to note that Bessie Head was initially brought up as a Christian however she was later influenced by Hinduism (to which she was exposed through South Africa's Indian community).

Most of her writing took place while she was in exile in Botswana. An exception is the early novel The Cardinals (published posthumously), written before she left South Africa.

In some ways Bessie Head remained an outsider in her adopted country, and some discern she had something of a love-hate relationship with it. At times she suffered mental health problems and on one occasion put up a public notice making bizarre and shocking allegations about then President Sir Seretse Khama, which lead to a period in Lobatse Mental Hospital. A Question of Power is based partly on those experiences.

In 2007 the Bessie Head Heritage Trust was established, along with the Bessie Head Literature Awards. In July 2007 the library in Pietermaritzburg was renamed the Bessie Head library in her honor.

In 2003 she was awarded the South African The Order of Ikhamanga in Gold for her exceptional contribution to literature and the struggle for social change, freedom and peace.