Monaco was also Playboy "Playmate of the Month" for April 1997, and portrayed Livvie Locke on the soap opera Port Charles from 2000 through 2003.

When that program ended, she joined the cast of the ABC soap opera General Hospital, of which Port Charles had been a spinoff, as Samantha McCall[10] in October 2003.

In 2003, Monaco was nominated for a Daytime Emmy Award for Outstanding Supporting Actress in a Drama Series for her role on Port Charles.

In 2006, she was again nominated for a Daytime Emmy, this time for Outstanding Lead Actress in a Drama Series for her role as Sam McCall on General Hospital.

[12] Among the events she experienced before her victory was a wardrobe malfunction in which the skimpy strap on her dress came apart during a Latin dance number.

[16] In February 2009, Monaco expanded her dancing résumé with Peepshow, a burlesque act directed by Tony Award-winning director Jerry Mitchell, that plays at the Planet Hollywood Resort and Casino in Las Vegas.

In November 2017, Monaco returned to twenty fifth season of Dancing with the Stars in week eight,[22] to participate in a trio rumba with Terrell Owens and his professional partner Cheryl Burke.

[7][25] On October 24, 2009, as part of the iParticipate campaign, Monaco and several of her General Hospital co-stars volunteered to help beautify a school in Los Angeles.