Medici Tower is encountered in the story modes of several characters in Skullgirls, and is unlocked by default for use in multiplayer and training.
Since the June 7 2014 patch update, Medici Tower now has two stage variants which alternate randomly each time the stage is selected, with one variant showing Lorenzo conversing with other mafia members and the other by himself bored.
Though Medici Tower is a massive complex, the stage itself merely takes place on its spacious elevator as it ascends upwards. After a lengthy ride, the elevator stops at the tower's apex, the office of Lorenzo Medici. The bright neon lights of New Meridian shine in through the windows as Lorenzo idly talks to his guests, Ottomo and Vitale, while Black Dahlia keeps a vigilant eye.
Medici Tower features prominently in the story modes of several characters.
- In the conclusion to Peacock's story mode, Peacock bravely trots into the tower in a scheme to take out Lorenzo and his henchmen as revenge for supporting the slavers that abducted her.
- In the conclusion of Cerebella's story mode Vitale sits in his father's chair as he celebrates the return of the Life Gem.
- In Squigly and Big Band's story modes, Medici Tower is brutally destroyed by Marie, its upper half torn away from the rest and broken into pieces against Lorenzo Medici's escaping airship. The lower half can be seen burning vividly in New Meridian's skyline.
- Medici Tower was visually updated in the June 7, 2014 patch "to be much more interesting and up to the standards of newer stages." Spotlights were introduced, neon billboards flicker and flash, and the elevator's glass windows now reflect parts of the scenery.
- A cameo of Filia can be seen as the elevator ascends, on the third ascending concrete platform to the far right of the stage. If Filia is present on the teams of either player, her cameo will be absent.
- Despite the fact that he cut ties with the mafia, Marcus' portrait is still hanging on the wall of Lorenzo's office.