Born Millicent Small in Clarendon, she was the daughter of an overseer on a sugar plantation and was one of the very few female singers in the early ska era in Clarendon. She was already recording in her teens for Sir Coxsone Dodd’s Studio One label with Roy Payton.

Her fourth recording, "My Boy Lollipop," cut in London by a group of session musicians that included guitarist Ernest Ranglin and featuring her childlike, extremely high-pitched vocals, was the first (and indeed, one of the few) international ska hits and introduced global audiences to the bluebeat style. It remains one of the biggest-selling reggae or ska discs of all time.

Small, who was known as "the Blue Beat Girl" on her album, was perceived as a one-shot novelty artist from the start because of her unusual, high-register vocals.

Although she continued to tour for a few more years, by 1973 Small had more or less retired from the music industry. In spite of her public reticence, she granted a handful of interviews over the following decades.

Jamaica awarded her a Medal of Appreciation and later, in 2011, granted her the Order of Distinction for her contributions to Jamaican music.