Sanger's career as a performer was launched when he won first prize in two international competitions: St Albans, England in 1969 and Kiel, Germany in 1972. Since then, he has toured as a solo recitalist. His discography spans the music of several centuries, and includes the complete organ works of Franck, the complete organ symphonies of Louis Vierne, and works by Liszt and Lefébure-Wély. Also, he has embarked on recording the complete organ music of Bach for Meridian Records.
In addition to his performing career, Sanger is also a teacher of the organ. He was professor of organ at the Royal Academy of Music in London, and chairman of the organ department there from 1987-89. Between 1989 and 1997 he was a Consultant Professor at the RAM. He was guest professor for two years at the Royal Danish Academy of Music, Copenhagen. Currently he is a Visiting Tutor in organ studies at the Royal Northern College of Music, and teacher of organ at Oxford and Cambridge Universities.
He is currently the president of the Royal College of Organists.