A quiet boy who sat in the back of the class, Ikuo was frequently absent from school due to his weak heart. In "Rough Sketch", he was among the students who welcomed Kōichi to Class 3 on his first day.
Later, he was seen in the background in "Blueprint", sketching with the others. He sits at the same table as Kōichi, San Watanabe, and Megumi Tatara.
Ikuo was seen in "Bone Work", where he walked home with a dark blue umbrella and a light blue backpack.
In "Put Flesh", Ikuo stared at Kōichi when he arrived with the rest of the class. He was seen in the background again, reading a book (what could even be a manga) and even resting by closing his eyes.
Ikuo was one of the students Izumi pulled into the all-class meeting to discuss her new countermeasures. In "Build Limbs", when Kōichi asked him and Yūya Mochizuki to walk home with him, Ikuo was willing to tell him the truth, saying how he didn't like how Izumi Akazawa was handling the situation. Before he could reveal anything, however, he suffered a fatal heart attack. He is one of the "Deaths of June."
Ikuo later appears in Kōichi's nightmare in "Body Paint", accusing Kōichi of causing his death, suggesting Kōichi felt guilty about it.
In the manga, his death is off-screen and is only mentioned by Yūya, who received this news in a phone call. Unlike the anime, in the manga, his death was the catalyst for the class ignoring Kōichi, rather than being caused by it.