How ‘General Hospital’ said goodbye to Kelly Monaco in final episode after shock exit

“General Hospital” fans are mourning Sam McCall — spoiler alerts below!

Kelly Monaco’s final episode as the iconic character ended on Friday, November 1, after McCall donated her liver to Lulu Spencer. We now know what happened to make that decision fatal.

Earlier this week, viewers learned that the doctors had successfully removed her organ, but Sam lost her life in the process. Fast-forward to Friday, when McCall’s mom, Alexis (Nancy Lee Grahn), told Sam’s longtime lover, Dante (Dom Zamprogna), that she had a heart attack after the surgery.

Carly (Laura Wright), Sonny (Maurice Benard), Drew (Cameron Mathison) and Laura (Genie Francis) all learned of McCall’s death in this episode, despite Laura having a sneaking suspicion that something happened when she saw Dante in tears at the hospital.

Dante begged Alexis to disclose what happened to McCall, begging her, “How can she be gone? It doesn’t make any sense!”

Alexis explained that the heart attack came out of the blue.

“She was showing me her engagement ring,” she said, weeping. “Then she said she couldn’t breathe and then closed her eyes.”

The actress who plays Alexis addressed Monaco’s departure before the last episode aired, revealing saying goodbye was just as hard in real life.

“As hard as it may be for #gh viewers to watch today’s episodes and the episodes to follow, it was equally as hard for me and my casemates to play. Playing Kelly Monaco’s mom has been effortless and the love is real,” Grahn wrote via X on Thursday.

Fans immediately wished the soap opera star farewell.

“Today, we say goodbye to Kelly. Our hearts are breaking 💔. I wish her all the success in the world. We love you, and you will be missed,” one viewer wrote. “Sam McCall was one of the few consistent leading female characters on #GH for the last two decades. Kelly Monaco was on the key art for virtually her entire tenure. Her face became synonymous with the words #GeneralHospital. It is surreal that she will no longer be on the show,” shared another.

Monaco shared a photo of her final “General Hospital” scene on social media last month, writing that her exit “still doesn’t make any sense to me.” However, she later deleted it.

The actress sparked a firestorm when she labeled her departure from the soap opera after 21 years as “retaliation.”

Responding to a fan on Soap Hub who claimed Monaco left because she “didn’t take the pay cut,” the star wrote, “‘No primary role’.. do your homework. When Billy Miller was fired, Sam’s storyline stopped. Stripping Sam of every characteristic she had. Something I worked for decades to build… Slowly dismantling her, into a character that I did not recognize, let alone the audience. Call it what you will… retaliation at it [sic] finest. I will give a proper statement. The truth will set you free.”

Days before Monaco blasted her exit, her mother addressed her fans.

“I want to take this moment to reach out to Kelly’s incredible fans and express my deepest gratitude for the unwavering love, loyalty, and support you’ve shown her throughout her time on General Hospital,” she wrote via social media on Sept. 28. “On this final day, just four days shy of the anniversary of her first episode on October 1, 2003, Kelly will close the door of her dressing room for the last time.”

Monaco was reportedly “blindsided” by ABC’s decision to kill off her character as she’s starred in over 2,000 episodes of “General Hospital.”

She first appeared in the town of Port Charles in 2003. The star earned a Daytime Emmy nomination for Best Supporting Actress

Before she was Sam McCall, Monaco played Livvie Locke from 2000 to 2003 on the “General Hospital” spinoff “Port Charles.”