The opera begins at Beijing Airport. A detachment of Chinese troops marches on to the stage and sings a 1930s Red Army song, The Three Main Rules of Discipline and Eight Points of Attention. As the soldiers wait, an airplane taxis and lands on the stage - the Nixons and Henry Kissinger disembark and are greeted by Chou Enlai. As Nixon is introduced to various Chinese officials by Chou, he sings of his hopes and fears for his historic visit.
Later, Richard Nixon and Kissinger visit Mao's study along with Chou. While Nixon attempts to set out his stall with a simple and simplistic vision of peace between America and China, Mao wishes to discuss philosophy with Nixon and speaks in riddles. The visit is not entirely a success, and the elderly Mao is soon worn out. Chou departs with Nixon and Kissinger.
On the first night of the visit, a great feast for the American delegation is held in the Great Hall of the People. The Nixons and Chou gradually relax in one another's company as good food and strong drink takes its effect. Chou rises to make a toast to the American delegation, full of fulsome praise and wishes for peaceful co-existence. Nixon responds in kind, congratulating the Chinese for their hospitality and recanting his previous opposition to China. The party continues with mutual compliments and toasting.
Pat Nixon is being escorted to various showcases of contemporary Chinese life - a glass factory, a health centre, pig farm and a primary school. However, the language of Pat's Chinese guides is stilted and formal - they hint darkly of the repressive side of Chinese life that lies underneath the façade shown to foreign dignitaries. Pat sings an aria of her own hopes for the future, a peaceful future of modesty and good neighbourliness, a future based on the values of the American heartland.
Later that night, the Nixons attend the Chinese opera, to see a piece written by Madam Mao called The Red Detachment of Women. The piece is a simplistic display of politicised music-theater, with the oppressed peasants of a tropical island saved from their brutal landlord by heroic women of the Red Army.
However, somehow the main characters are drawn into the opera, each revealing their true nature, with Pat Nixon defending the weak, Kissinger siding with the brutal landlord and Madam Mao's desire to save the peasants at all costs leading her to become more brutal than the landlord was in the first place. Eventually, a riot develops on stage with Chou and Madam Mao on opposite sides - the opera has become a rerun of the Cultural Revolution.
On the Americans' final night in Beijing, it has become apparent to all that there will be no great breakthrough the Shanghai Communique is no more than words, a face-saving formula for the world's press to buy into. The main characters look back over their lives the Maos and the Nixons look back to the struggles of their early years together, Richard Nixon recalls his younger days as a sailor. Only Chou looks deeper, asking "how much of what we did was good?", before casting doubts aside and wearily carrying on with his work.