- Directors: Darren Lynn Bousman
- Producers: Darren Lynn Bousman, Mark Burg, Oren Koules, Peter Block, Yoshiki Hayashi
- Writers: Darren Smith, Terrance Zdunich
- Genres: Fantasy, Horror, Musical
- Actors: Alexa Vega, Paul Sorvino, Anthony Stewart Head, Sarah Brightman, Paris Hilton, Bill Moseley, Ogre, Terrance Zdunich, Sarah Power
The movie is set in the year 2056; 26 years after an epidemic of organ failures devastated the planet. Out of the tragedy, the Bio-Tech Company GeneCo, run by Rotti Largo, emerged to provide organ transplants to the needy populace. Through his efforts, Rotti also got approval to create the Repo Men, assassins dispatched to deal with customers who default on their payments. In the present time, 17 year-old Shilo Wallace explores the cemetery where her mother is entombed. Hiding from GeneCop searchlights, she runs into the GraveRobber, a dealer of an addictive, expensive, painkiller Zydrate. Encountering GeneCops, Shilo passes out and awakens in her house, where her overprotective father, Nathan, has kept her locked all her life. Shilo has been suffering from an apparent blood disease inherited from her mother, Marni, who died taking a â€œcureâ€ invented by Nathan. While Shilo believes he is a doctor, Nathan is actually one of GeneCoâ€™s Repo Men.
Meanwhile, Rotti Largo, who is dying, views Shilo as a possible heir. He refuses to consider his bickering children, Luigi Largo, Pavi Largo, and Amber Sweet, viewing them as â€œvultures and ingrates.â€ Rotti, formerly Nathanâ€™s rival for Marniâ€™s affections, and secretly, her killer, asks Shilo to meet with him at the cemetery. When they meet, Rotti tells Shilo of a cure for her condition before introducing her to his GeneCo Genetic Operaâ€™s star singer, Blind Mag. While Blind Mag announces her retirement to the public, Shilo is taken to a tent to be guarded by a few henchgirls. Unfortunately, her father calls her during work to remind her to take her medicine, which nearly causes Nathan to come home early.
Arriving at Shiloâ€™s house to invite her to the Genetic Opera, Mag reveals to her that she is her godmother. After she warns Shilo to not make the same mistakes she did, Nathan arrives home and kicks Mag out. This prompts an argument between Nathan and Shilo, which ends when Nathan slaps her, causing her to pass out. Later that night, the characters converge at the Genetic Opera. At the performance, Amberâ€™s stage debut bombs when her face falls off. During Magâ€™s performance, she gouges out her eyes and is dropped to her death by Rotti onto a metal fence. After convincing the audience it was part of the show, Rotti instructs Shilo to capture the Repo Man for her cure. Attacking the Repo Man back stage with a shovel, Shilo discovers, to her horror, that itâ€™s her father. Rotti then reveals to Shilo that her condition was caused by â€œmedicationâ€ provided by Nathan, who says that he did so to keep her from the outside world. When Shilo refuses to accept Rottiâ€™s offer to inherit GeneCo by killing off her father, Rotti shoots Nathan himself before expiring from his disease. After she and her father exchange final goodbyes, Shilo leaves the stage, free from her Genetic destiny. The following day, as revealed by the GraveRobber, Shilo turned down inheriting GeneCo. Instead, Amber took over and auctioned off her face to charity. Pavi won after Luigi killed the top 3 bidders.