As The Fame Monster dealt with topics of overexposure and toxic celebrity culture, including the paranoia Gaga herself had experienced, the main theme of the shows became personal growth and human evolution, while elements of the originally planned tour (with Kanye West) were retained in some parts.

From 2010 on, the shows took on a "Big Apple" theme, telling a story in which Gaga and her friends are lost in New York City and must find their way to the "Monster Ball".

HBO recorded a special of The Monster Ball during Gaga's February 2011 shows at Madison Square Garden in New York City; interspersed with backstage footage and interviews, Lady Gaga Presents the Monster Ball Tour: At Madison Square Garden aired on HBO in May 2011 and was released on DVD and Blu-ray on November 21 of that year.

[6] Gaga addressed the situation at Billboard's annual Women in Music luncheon, where she cited creative differences as the reason for the tour's cancellation.

[9][11] The official poster for the tour featured Gaga in Versace 676 sunglasses and wearing a gyroscope around her called "The Orbit", which she first wore on the October 3, 2009, episode of Saturday Night Live.

[13] In an interview with Rolling Stone, Gaga explained that she wanted to put together an expensive looking, beautiful show which would be affordable for her fans.

'"[16] In December 2009, Gaga revealed that she planned to cancel the concept of the original shows of The Monster Ball Tour and start afresh.

[23] After the song, Gaga strapped a portable silver jeweled keyboard to herself and began to perform "Just Dance" while emerging from the inside of a white cube on a platform.

[21][22] This was followed by a brief video intermission and Gaga returned onstage in an off-white costume, that resembled an alien ecto-skeleton, while the dancers wore skeletal headgear.

This segment was followed by the performance of "Fashion" and "The Fame", during which Gaga wore a gold Egyptian styled crown and matching body suit,[21] compared to the garment of a viking.

[26] During "Poker Face", she wore a bondage inspired black leather dress with guns hanging from it and a hat made of muzzles,[27] and pumped her hands in the air while performing the song.

Gaga then performed "Beautiful, Dirty, Rich" while scaling various pieces of scaffolding[18] and subsequently "The Fame" where she rose from beneath the stage and played her keytar Emma, wearing a giant red cape.

[18] After a costume change, Gaga burst into "Money Honey" with an extended keytar solo after emerging from beneath the stage as the New York scenery disappeared around her.

[18] Gaga starts singing "Paparazzi" and eventually kills the Fame Monster by shooting sparks from her pyrotechnic bra and underwear.

"[23] Aidin Vaziri of San Francisco Chronicle said that "During her 90-minute performance—not so much a live concert as a meticulously choreographed spectacle—Lady Gaga also evoked Kanye West with the futuristic set, Britney Spears in her heavy-lidded stage movements, Courtney Love with her interminable between-song monologues highlighted by four-letter squelches and—who else?—Madonna for, oh, just about everything else.

"[26] Los Angeles Times writer Ann Powers avouched that the tour was "an invigoratingly ambitious show, executed with vigor by its star and her expressive dancers.

"[35] Jon Pareles from The New York Times said that the tour always provided "something worth a snapshot: a sci-fi tableau, perhaps, or a skimpy, glittery costume.

Savage described the concert as a hugely ambitious, terrifyingly loud show, "spread over four acts and held together by a flimsy 'narrative' about Gaga and her dancer friends trying to get to a party."

He said that the tour was "packed with more wattage than an overheated power plant and more costume changes than a thousand Vegas reviews, it's the kind of show that leaves you with wide eyes, ringing ears, aching limbs and absolutely zero chance of making it to work in the morning.

For every coat made of Kermit the Frog dolls or headdresses that covered her face in red lace, there was a stomping disco anthem or tender piano ballad to match.

[38] Philip Borof from Bloomberg Television reviewed the concert in New York's Madison Square Garden and found it average, calling the crowd decked in various costumes as the "most entertaining".

"[40] Mariel Concepción from Billboard felt that Gaga "may be best known for her gaudy outfits and over-the-top stage shows, but at her hometown headlining debut at Madison Square Garden last night, the pop phenomenon proved she's a regular girl at heart.

"[41] The Seattle Times staff writer Marian Liu declared that as "one of the most anticipated touring acts of the year, [Gaga] stimulated the crowd's senses on Saturday night in a way few artists can.

Bob Stohrer, VP of Marketing for Virgin Mobile USA said "We are excited to take our partnership with Lady Gaga and The Monster Ball Tour to another level.

"[44] Shows in the first leg of the tour were sold-out completely, prompting Live Nation Inc. to announce that Gaga will return to the U.S. in February 2011 for another run of U.S. dates.

[51] Gaga's show at the United Center in Chicago became the highest-grossing concert of the third American leg; it earned an estimated US$1.8 million from 15,845 sold seats at a February 28, 2011 performance.

The 5.1 surround sound of the release utilized DTS-HD Master Audio and new technology to provide the viewer an optimum experience of watching the live concert.

[63] The release was a commercial success, reaching the top of the DVD charts in the United States, France and Italy and the top-ten in other nations.

[67][68] On April 9, 2020, the Lady Gaga media site GagaFrontRow shared a direct screen recording of the Philadelphia show on September 14, 2010.

This is the first full version of the concert ever released to the public since the HBO special and subsequent DVD removed many elements of the show, including half of the first song "Dance in the Dark".