On October 14, 2018, Tuhtaboyev impressed in his Lethwei debut, when he dominated in his fight against local hero Phyan Thway. The performance of the Uzbek fighter caught the attention of World Lethwei Championship.

In 2019, Tuhtaboyev signed an exclusive Lethwei contract with World Lethwei Championship and challenged the undefeated and reigning World Lethwei Middleweight Champion Too Too. both men had previously fought each other under Muay Thai rules in Thailand in 2014, with Tuhtaboyev emerging victorious by split decision.The fight was a back-and-forth fight-of-the-year candidate. Since then, Too Too had been celebrated in his home country of Myanmar, winning the WLC Middleweight title in 2018. Meanwhile, Tuhtaboyev had been more focused on Muay Thai, having been involved in several big fights. In their Lethwei rematch, the WLC Middleweight World Championship would be on the line.

On January 31, 2020, Tuhtaboyev faced Too Too inside Thein Pyu Stadium, with the spectacle being streamed live across 70 countries. Both fighters were hunting for the knockout, with Too Too being effective with his leg kicks and headbutts. However, Tuhtaboyev’s more precise and accurate strikes proved to be the difference and earned him the victory via split decision, making him the first man to defeat Too Too in more than 3 years and the new Middleweight World Lethwei Champion.