In a dystopian future the world is ruled by the GeneCo corporation offering plastic surgery, organ transplants, and the drug Zydrate. A teenaged girl named Shilo dreams of seeing what life is like beyond her bedroom window. Her father Nathan, one of Geneco's grisly Repomen tasked with repossessing unpaid organs, tells her she is ill and hides her away to keep her from the truth of his career and her mother's death.
Years earlier Nathan married a woman named Marnie, the former lover of Rotti Largo, the head of Geneco. Angry Largo secretly killed her but made Nathan believe that he was responsible. Grief-stricken, Nathan was coerced by Largo to become a hated Repo Man with the promise that he would never reveal to Shilo that her own father killed her mother.
When Shilo's idol, an opera singer named Blind Mag who was given new eyes by Geneco, makes her farewell performance Shilo sneaks out to see it and is confronted by Largo. Still bitter over Nathan and Marnie's betrayal, Largo takes the opportunity to manipulate Shilo. Rotti has learned that he is dying himself and believes that the ultimate revenge on Nathan will be to turn Shilo against her father and make her the heir of his company. He convinces her that a rogue Repo Man wants Blind Mag's eyes and that she must attack the Repo Man when he shows up at the show.
During Mag's final performance, Largo secretly kills the singer and Shilo attacks the Repo Man only to find it is her own father. Shilo is told by Largo that her own father has been poisoning her to make her sick and that she must kill Nathan if she wants to inherit Geneco. Although Shilo is angry at her father for all of his lies, she still refuses and Rotti shoots him before dying himself of his terminal sickness. Shilo refuses Geneco and disappears, a victim of lies and vengeance.