Links two actions performed at the same time by one subject ('while doing X'), and with も it adds a concessive nuance ('even though / despite doing X'). The も version often implies an inner conflict — doing one thing while knowing or feeling the opposite. More formal than ~ながら.
[Verb ます-stem] + つつ(も)
悪いと知りつつも、嘘をついてしまった。
Warui to shiritsutsu mo, uso o tsuite shimatta.
Even though I knew it was wrong, I ended up lying.
知り (stem of 知る) + つつも = 'despite knowing', showing internal conflict
音楽を聴きつつ、宿題をした。
Ongaku o kikitsutsu, shukudai o shita.
I did my homework while listening to music.
聴き (stem of 聴く) + つつ = two simultaneous actions
やめようと思いつつも、つい食べすぎてしまう。
Yameyou to omoitsutsu mo, tsui tabesugite shimau.
Even though I keep thinking I'll stop, I end up overeating.
思い (stem of 思う) + つつも = concessive 'despite thinking'
• Register: formal / literary; spoken speech prefers ~ながら or ~のに. • With も it is concessive ('even though'); without も it means plain 'while'. • Both actions must share the same subject.
The JLPT rarely asks whether you recognise a pattern — it asks which of several similar patterns fits. These are the ones ~つつ(も) is tested against.
~ながら is neutral and common in speech; ~つつ(も) is formal and, with も, carries a stronger 'despite' nuance.
~のに expresses simple contrast/frustration; ~つつも links a simultaneous action with concession by the same subject.
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