Repo! is a rock opera that works hard to appeal to the goth crowd through clothes, blood, and drugs. Don't watch it expecting anything else.
In the future, there is a vague "organ failure epidemic" that only serves to give rise to your standard evil corporation that kills people - GeneCo. To keep themselves relevant after people stop dying of organ failure, GeneCo introduces a new trend, surgery as fashion statement.
Oh yeah, they also make an addictive painkiller, Zydrate, which gets a few songs, but does not seem to impact the plot at all.
GeneCo is run by Rotti Largo, who is your typical evil tycoon. He pushes through a law that gives GeneCo the right to hunt people down and cut out their replaced organs when they fail to pay their medical bills. Rotti decides that the position of head Repo Man should be given to the man to stole his fiancee, Marni:
Giles Nathan Wallace.
Anthony Stewart Head, upon realizing that his Repo Man voice is even more ridiculous than Christian Bale's Batman voice.
After Nathan married Marni and got her pregnant, Marni became sick. Nathan tried to cure her, but Rotti secretly replaced the cure with poison. As Marni died, Nathan performed a C-section on her in order to save the baby, Shilo.
Not to be confused with the dog.
All of this happens 17 years before the opera actually starts.
Shilo grows up with some blood disease that makes her have to wear a wig and...not go outside. Which she does a lot. And complains about not being able to do. Despite outside looking like this:
Also, everyone's into bondage.
Rotti is dying, and he hates his children, so he decides to leave GeneCo to Shilo. Half of the movie is him making Nathan and Shilo upset. The other half is Nathan and Shilo arguing over whether or not 17 is old enough to leave the house. Also angst. Lots of angst.
There's a subplot with an opera singer who was best friends with Marni, but it doesn't amount to anything more than "I knew your mother, you look a lot like her, okay, I'm going to die at a dramatic moment now." There's also another subplot with Rotti's children arguing over who gets the company, but as we already know Rotti has picked Shilo, we don't really care.
The movie ends with Shilo finding out that not only is her father Repo Man, he has been poisoning her in order to keep her at home. Rotti tells her that if she kills her father, he will sign his will leaving GeneCo to her.
Which only proves that Rotti is the laziest man in the world.
Shilo refuses, so Rotti shoots Nathan, then conveniently dies from his unnamed terminal illness. Shilo and Nathan then sing a song to each other while Nathan dies.
For some reason, no one in the audience thinks to dial 911.
After Nathan dies, Shilo walks out of the theater singing about how her life isn't decided by her genes and she gets to make her own choices and all that vaguely uplifting finale stuff. Rotti's children also announce that GeneCo will not close, but will instead be run by Paris Hilton.
Not pictured: Good business sense.