Tyler Perry reprised Madea and Joe, and the other cast members include Loretta Devine, Bow Wow, David Mann, Cassi Davis, Tamela Mann, Lauren London, Isaiah Mustafa, Natalie Desselle, Rodney Perry, and Shannon Kane.

While visiting Dr. Evans with Aunt Bam, Madea's niece, Shirley, discovers her cancer has gotten worse and she may only have a few weeks to live.

Meanwhile, Madea drives through Snax, a restaurant, because Sabrina, its young manager, delayed taking her order until after breakfast was over for the day.

Shirley's children are Byron, on probation for selling drugs and in a relationship with selfish, gold-digging Renee with a son from a previous relationship; Tammy, who has marital issues with her husband Harold and their undisciplined children; and Kimberly, filled with anger issues and mistreats her husband Calvin, her son C.J.

Afterward, Byron is humiliated by Sabrina on Maury and returns to the drug trade, while Calvin leaves Kimberly and takes C.J.

Over time, Shirley's condition worsens, and she is rushed to the hospital, where she reveals to her children (sans Kimberly) that she has cancer, tells her family that she loves them and later dies.

At the wake, Madea intimidates Sabrina to stop hassling Byron, abusing his hard-earned money, and using their child to make his life miserable.

She then confronts Byron that he should care for his son by getting a stable job, warning him if he continues down the wrong path, he will end up dead or back in prison, and that once he goes down, Renee will just move on to the next man with the most money.

Madea also reveals that Kimberly was raped by her paternal uncle when she was 12, resulting in her having Byron at 13, and explaining her bitterness and anger towards her family.

The DVD features four featurettes: "By-reen: The Baby Mama from Hell", "Ties That Bind", "Madea's Family Tree", and "Brown Calls Maury".