[5] She then left for Italy to complete her vocal studies at the Accademia Nazionale di Santa Cecilia in Rome, with Luigi Ricci and Nazzareno De Angelis.
She sang 687 performances of 54 roles there, including Bersi in Giordano's Andrea Chénier, the title role in Bizet's Carmen, Rosina in The Barber of Seville, Laura in La Gioconda, Suzuki in Madama Butterfly, Siebel in Faust, Nancy in Martha, Cherubino and Marcellina in The Marriage of Figaro, Dorabella in Così fan tutte, Octavian in Der Rosenkavalier, Olga in Eugene Onegin, Marina in Boris Godunov, Fenena in Nabucco, Azucena in Il trovatore, Amneris in Aida, Charlotte in Werther, and The Witch in Hansel and Gretel.
In the realm of live broadcasting, Elias' performance as Bathsheba under the direction of Alfredo Antonini for CBS Television's premiere of Ezra Laderman's opera And David Wept, earned Ellias critical acclaim in 1971.
In 1984, Elias made her New York City Opera debut as Mrs. Lovett in a return engagement of Hal Prince’s original staging of Stephen Sondheim‘s Sweeney Todd: The Demon Barber of Fleet Street.
[1] Still in lustrous voice, Elias played the role of "Heidi Schiller" in a new revival of James Goldman and Stephen Sondheim's 1971 musical Follies, which ran at the John F. Kennedy Center for the Performing Arts from May 7, 2011, to June 19, 2011.
[15] Elias, who had been diagnosed with congestive heart failure in 2019, was admitted to Mount Sinai West on April 30, 2020, after suffering breathing problems.