Aaron and his twin brother, Marion "Lindberg" Sparks, were born in Corona, Lee County, Mississippi, to Sullie Gant and Ruth McWhorter. They later took the surname of their stepfather, Carl Sparks. In 1920, the family moved to St. Louis, where Pinetop had "rudimentary music education at school". He and his twin brother formed a group, with Aaron playing the piano in a boogie-woogie style and Marion singing. They were accompanied by the guitarist Pete Bogans and the trombone player Ike Rogers. The boys had a sister, Jimmie Lee, who never recorded songs but, according to Henry Townsend, had a wonderful singing voice. Townsend recalled in his memoir that Pinetop played, like all other St. Louis musicians, in the "speakeasy type places", such as Nettie's on Delmar Boulevard. Their first recording session was in 1932, when they recorded a number of blues and boogie-woogie songs. Pinetop (who got his nickname from playing Pinetop Smith's hit "Pine Top's Boogie Woogie") has been praised for "excellent technique", capable of both "fierce boogie-woogie style" and "chorded basses and rich treble passages" to accompany his brother. Pinetop also recorded "Bad Luck Blues" with Dorothea Trowbridge and "Whiskey Blues" with Elizabeth Washington, both in 1933. Most often, the brothers played together only occasionally. Notable recordings by Pinetop include a version of "Every Day I Have the Blues", recorded in 1935 and reissued on the compilation album Windy City Blues (Nighthawk, 1992). In that same year, on 28 July, he recorded his version of "Every Day I Have the Blues", a song he wrote with his brother, released by Bluebird Records (catalogue number B-6125). In 1949, the song was recorded under a different title by Memphis Slim.
There are rumors the brothers did not always get along and did not have steady employment, working in the bars and clubs of St. Louis. The brothers also frequently had run-ins with the law. Pinetop drank heavily, and Lindberg killed a man (in self-defense), for which he spent time in a workhouse in 1937. Pinetop died, apparently of poisoning, in 1935. Townsend, however, claims that his brother died of exhaustion: Pinetop was in the habit of never saying no to a gig, playing all throughout the weekend and would consequently work 24 hours without sleep. According to Lindberg, it was these work habits, combined with heavy drinking (to stay awake), that led to Pinetop's death. "He just done burned himself out", according to Townsend. Townsend lived a more calm and respectable life until a heart attack in 1963. Pinetop Sparks' grave went unmarked for nearly eight decades, before a fan club finally honored him. In 2014 – 78 years after Sparks' death – thanks to the work of a non-profit organization, the Killer Blues Headstone Project, a headstone was laid at Father Dickson Cemetery in Crestwood, Missouri, a historically black cemetery in St Louis. A keyboard adorns the lower casing of the stone, with his name, dates of birth and death, and the epitaph "Every Day I Have the Blues".