Taking place in eighteenth-century Italy, it follows the paths of two unlikely collaborators: a Venetian noble and a maestro castrato from Calabria, both trying to succeed in the world of the opera.

Set in eighteenth-century Italy, Cry to Heaven focuses on two characters, peasant-born Guido Maffeo, who is castrated at the age of six to preserve his soprano voice, and fifteen-year-old Tonio Treschi, the last son of a noble family from the Republic of Venice, whose father, Andrea, is a member of the Council of Three of La Serenissima.

As he was raised to be a gentleman, and because he was castrated relatively late in life, he continues to act like a man, unlike the more effeminate poses of castrati boys.

Although he is almost booed off the stage for upstaging the operatic star Bettichino, he proves a great success, and both he and Guido have a bright futures in front of themselves.

Intoxicated, Carlo not only curses ever coming back to Venice, but also wants to take Tonio's place, finding the city decadent and confining.

With the completion of her second novel, The Feast of All Saints (1979), American author Anne Rice started her research for another, which she planned to set during the French Revolution with a violinist as its protagonist.

[2] For the settings, she relied on her travels to Venice and Rome a few years earlier, and read the diary of German author Johann Wolfgang von Goethe detailing his trip to Naples, although she found a lack of material on the conservatories.

[3] Rice wrote the first two hundred pages of Cry to Heaven as a contrast to Tonio's life as a castrato for the rest of the novel.

[4] She quickened her narrative pacing to suit her audience, in an attempt to remedy an issue that she felt had hindered the success of The Feast of All Saints (1979).

[5] Parts of her largely unpublished novella Nicholas and Jean (1966) were incorporated into Cry to Heaven, among them a female role being played by a man.

[17] Michiko Kakutani of The New York Times called it a "dark, humid melodrama" and enjoyed the historical details and Tonio's "emotional development", although she wrote that the secondary characters were two-dimensional and superficial.

[18] Writing for The Los Angeles Times Book Review, Pat Hilton wrote that, excepting the conclusion, Cry to Heaven was "satisfying", and felt that its questions about masculinity were contemporary.