The opera has four acts and ACT 1 opens at a banquet hosted by Grigory Gryaznoy, a powerful member of Tsar Ivan's secret police, the oprichniks. Gryaznoy is brooding. He's in love with young Marfa, but she's engaged to the nobleman Likov. Gryaznoy is determined to prevent their marriage, no matter what it takes.
Likov is among the guests at the banquet, and sings of the adventures he's had on a recent trip to Germany. Others in the room include a German doctor, Bomelius; another oprichnik, the ruthless Malyuta; and Gryaznoy's mistress, Lyubasha. She was kidnapped by the oprichniks from a small village, and entertains the gathering with a traditional folk song.
As the party winds down, Gryaznoy calls Bomelius aside — while Lyubasha stands in the shadows nearby to eavesdrop. Gryaznoy wants to know if Bomelius can whip up a love potion. Of course it's not for him, Gryaznoy says — he needs it for "a friend." Bomelius says he'll see what he can do.
Hearing this, Lyubasha fears that Gryaznoy has fallen in love with someone else. When all the guests are gone, she confronts him. He pushes her away coldly and leaves the house. Alone as the act ends, Lyubasha vows to find the woman Gryaznoy has fallen for and destroy her.
ACT 2 takes place on a Moscow street, where we can see both Marfa's house and the home of Dr. Bomelius. Superstitious neighbors are convinced that the doctor is some kind of sorcerer and up to no good.
Marfa is headed for home with her friend Dunyasha, and sings longingly about the return of Likov. Two men then appear on horseback, and one of them stares intently at Marfa. The men don't identify themselves, but the orchestra plays music associated with the tsar — hinting that the man with his eye on Marfa is Ivan himself.
When the two young women go into Marfa's house, Lyubasha appears outside. She's been watching, and suspects that Marfa is the woman Gryaznoy is now pursuing. She goes to Bomelius's house, and knocks at the door.
When the doctor answers, Lyubasha demands a potion that will destroy a woman's beauty. Bomelius says he can make one — but only if Lyubasha will become his lover. She refuses. But when she hears Marfa laughing, Lyubasha begins to reconsider. Then she sees Likov leaving Marfa's house — saying he'll be back tomorrow, and Gryaznoy will be with him. At that, Lyubasha again goes to Bomelius's door. He opens it, agrees to give her the potion, and takes her inside.
A crowd then appears on the street. They're running from the oprichniks, who threaten to destroy all the tsar's enemies.
As ACT 3 begins in Marfa's home, her plans to marry Likov are well underway. Her father Sobakin is discussing the wedding with Likov, and it seems the cunning Gryaznoy has agreed to serve as best man.
Still, they have yet to announce the betrothal in public. That's because the tsar himself is looking for a new wife. After considering some 2000 women, he has narrowed the field to 12, including Marfa and her friend Dunyasha. Until the tsar announces his choice, their futures are uncertain.
Dunyasha's mother Saburova enters, boasting that her daughter seems to have caught the tsar's eye. Likov is reassured, and a toast is suggested. Gryaznoy sneaks his potion into Marfa's glass and she drinks it. But with the celebration underway, the oprichnik Malyuta appears — and announces that the tsar has chosen Marfa as his bride. Marfa is bewildered, but she's now the future tsarina, and everyone kneels to her as the act ends.
ACT 4 takes place in the tsar's palace. Marfa has become seriously ill, and no one can find the cause. Gryaznoy appears with the bogus news that Likov has confessed to poisoning Marfa — and the all-too-real news that Likov was executed for his supposed crime. Hearing this, Marfa passes out. When she's revived, she's obviously disoriented and near death. She mistakes Gryaznoy for Likov, and speaks to him with deep affection.
Gyraznoy, who truly loves her, is overcome with guilt. He admits that he's the one who slipped something into Marfa's drink, saying he thought it was a love potion, so he's responsible for her illness. He goes to the violent oprichnik Malyuta, turns himself in, and asks for a gruesome punishment.
But Gryaznoy isn't the only one with a confession to offer. Lyubasha suddenly appears, admitting that she replaced the love potion with poison. She turns to Gryaznoy, saying she wants to die, and he stabs her. She dies smiling, saying, "You got me in the heart."
Gryaznoy is taken prisoner. As he's led away, Marfa is still delirious, and now seems close to death. Marfa looks at Gryaznoy fondly, still seeing him as Likov. She quietly tells him to "come again, tomorrow," and the opera ends.
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