The character of Franco is a multi-media artist and serial killer who becomes fixated on Jason Morgan (Steve Burton), a known hitman.

Franco's return brought about the revelation that his biological parents are Scott Baldwin (Kin Shriner) and Heather Webber (Robin Mattson).

[3] Sharing the same agent as Steve Burton, who played Jason Morgan on General Hospital, he went to that series for his request.

Ken Tucker of Entertainment Weekly compared the characters art installations to a rip off of Jean-Michel Basquiat and Keith Haring.

Maxie Jones (Kirsten Storms) accompanies Franco to his apartment, where he blindfolds her, photographs her in a chalk outline, and they sleep together.

Franco kidnaps Jason's girlfriend Sam McCall (Kelly Monaco) and his best friend Carly Corinthos Jacks (Laura Wright).

In June, Jason kills Carter (Josh Wingate), who had abused Michael (now Chad Duell) in prison, and his last words are "Franco says hi."

In an ensuing battle with Jason, Franco apparently jumps off the roof of the building,[3] although the crowd brushes it off as live entertainment.

As he leaves town, Franco is seen requesting his agent to book international model Brenda Barrett (Vanessa Marcil), who later turns down the offer.

In February 2011, Franco calls Jason and takes credit for the bombing of Brenda and Sonny Corinthos (Maurice Benard)'s wedding limo.

In September, Franco is seen taking photos and telling his toy monkey that Jason and Sam forgot his invitation to their wedding.

Jason wakes up in a locked room, with a TV screen that shows live footage of Franco carrying Sam, passed out, to the bedroom.

She goes to see Heather Webber (Robin Mattson), who reveals that her deceased cousin, Susan Moore (Gail Ramsey), was Franco's biological mother, making him Jason's fraternal twin brother.

Sonny orders Shawn Butler (Sean Blakemore) to perform a hit, but calls it off for fear of innocent people being harmed.

Carly lures Franco to the Metro Court and orders Shawn to perform the hit, making him believe it is with Sonny's approval.

His tumor is found to be benign and removed, but due to some cancerous cells he cannot donate bone marrow to Danny after his struggle with Epiphany Johnson (Sonya Eddy).

In November 2013, Heather reveals that she is Franco's biological mother and Scott Baldwin (Kin Shriner) is his father.

It turns out this jealousy, fueled by Franco's new friend and Silas Clay (Michael Easton)'s wife Nina Clay (Michelle Stafford) is "correct", as Kiki informs Franco that Carly slept with Sonny behind his back after he was employed as Art therapist at General Hospital by Chief of Staff and Nina's Aunt Liesl Obrecht (Kathleen Gati).

“I disrupted the audience's suspension of disbelief, because no matter how far I got into the character, I was going to be perceived as something that doesn't belong to the incredibly stylized world of soap operas.

[13] Vulture writers Jada Yuan called it "bizarre but fascinating",[14] and Lane Brown stated "the answer was either a drinking problem or a maniacal desire to be written about on more blogs.

[1] Others felt it was a smart move that would benefit Franco with publicity; New York Magazine wrote: "Joining General Hospital, and acting like it's just another gig, displays a ballsy disregard for conventional Hollywood wisdom, and adds a line to his résumé that has already generated more discussion than all the Spider-Man movies combined.

[23] Roberta Smith of The New York Times stated: "[Franco's appearances] earned him something of a cult following, although I can’t be alone in feeling that their irony is outdone by their lameness.

[29] Randy Kennedy of The New York Times spoke of Deitch and the General Hospital filming at MOCA in tandem: "That the museum had become a soap opera set was pure Deitch, for better or worse: stuntlike, crazily experimental, scrambling high and low culture, risking ridicule and seeming not to care much when it rains down on his head.

[29] In an interview with the Los Angeles Times Deitch compared Franco's appearances on the series to "the ultimate extension of Andy Warhol guest starring in The Love Boat.

"[31] The series won Daytime Emmy Awards for the episode filmed at MOCA,[32] although it received mixed reactions from viewers.

[33] James Franco's real-life documentary/fiction feature Francophenia (or Don't Kill Me, I Know Where the Baby Is) was shown at the 2012 Tribeca Film Festival, described as "an experimental psychological thriller set amid the spectacle of a celebrity’s escalating paranoia".

[34] Genna Terranova, Tribeca's director of programming, commented: "He's kind of constructed this really interesting and well-crafted film about that experience that plays with the boundaries of documentary.

He's a bit enigmatic and the film is as well.”[35] “James Franco's guest stint – or metaphysical investigation into the hall-of-mirrors recursion of celebrity, take your pick – on General Hospital was one of the few times in recent history that daytime television broke out into mainstream discussion, and it's hard to argue that the spotlight wasn't a boo[n] for the genre."

Soaps tend to be treated (unfairly) like a training ground for actors who want to achieve 'real' stardom elsewhere, so an artist of James's talent, youth, and fame level choosing to act there, even for two weeks, is like eating lunch alone in the cafeteria for two years only to have the hottest dude in school ask if he can sit with you and share a plate of fries.

[38] In 2023, Charlie Mason from Soaps She Knows placed Franco at #35 on his ranked list of General Hospital’s 40+ Greatest Characters of All Time, commenting "Once a fearsome villain, Liz’s latest late husband — thanks to the removal of that pesky homicidal brain tumor — became known as not only one of Port Charles’ biggest sweethearts but one of its funniest residents, too.