She is recognized for her black and white portraiture,[1][2] use of natural light and infrared photography, and images of sacred architecture.

[2][5][6] Her photographic work extends to the sacred in architecture and human artifact including the temples of Angkor Wat, Tibet and the Mayan pyramids.

[2][4][5] Since 1978, MacAdams has documented the history and life on the Bowery NYC through her portraits ranging from structures, to street people to resident artists and poets such as William Burroughs, Patti Smith, Anne Waldman, Kate Millett, Chuck Close, Robert Mapplethorpe.

[2][5] After graduating from Northwestern, MacAdams worked in summer stock and then,[9] in 1961 moved to New York and landed a part in the Broadway production of Nightlife by Sidney Kingsley.

It was during this period that MacAdams met two of her lifelong friends and mentors: the actress Shelley Winters and the photographer/filmmaker Robert Frank.

Cynthia captures them boldly, without trying to be complex or intellectual.”[5] In her artist’s statement for the book, MacAdams said: “I looked for women….. who had strength and softness in their eyes and a directness in the way they dealt with their life.”[1][5] Some of the "second-wave" feminists who are presented in the book include: Judy Chicago, Michelle Phillips, Gloria Steinem, Lily Tomlin, Jane Fonda, Phyllis Chesler, Laurie Anderson and Meredith Monk.

Portrayed were punk rockers at CBGB, artists and poets such as William Burroughs, Allen Ginsberg, Robert Mapplethorpe, and Anne Waldman.

[5][7][11] MacAdams also explored forms of sacred architecture in portfolios of Egypt, Tibet, Angkor Wat, Indian Temples, Celtic and Mayan ruins.