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The Genetic Opera is a performance that, within the plot of Repo! The Generic Opera, encapsulates Shilo, Nathan, and Rotti's final confrontation. The Opera itself functions as a marketing piece for GeneCo as all the performers and presenters are either recipients of GeneCo products and services, employees thereof, or both. Society seems to have accepted this as a cultural fixture, illiustrating the pervasive nature of GeneCo.

Structurally, the Opera bears little resemblance to an opera, having a set script, songs, and blocking and appears to be more like a talent or variety show with smaller acts and vignettes. One of the acts teased by Rotti, the curing of Shilo, suggests that curing, surgery, or other medical practice is one of the possible acts to appear at any given Opera.

Genterns and the Band Leader perform the opening of the Genetic Opera, wherein GeneCo customers are urged to "Testify!" ("We Started This Op'ra Shit!") about the surgical work GeneCo has performed on them.

Notably, Blind Mag is bound to perform in the Opera or risk the reposession of her GeneCo financed eyes.