The launch of the $3.4 billion new resort comes as Macau is undergoing something of a renaissance, with gaming revenues bouncing back after being hard hit by a corruption crackdown launched by China's President Xi Jinping in 2012.
The mega project's launch faced repeated delays, most recently in August when Typhoon Hato ripped a path of destruction across southern China, leaving 10 dead in Macau and businesses and homes washed out in the territory's worst typhoon for over 50 years.
Macau, a semi-autonomous territory, is the only place in China where gambling is legal, bringing in revenue that easily dwarves Las Vegas.
Macau's revenues took a hit after Xi declared his war on graft with many mainland big spenders staying away from the enclave, which had gained a reputation as a centre for laundering illicit money out of China.
More From This Section
In response to the crackdown Casino giants launched a slew of new mega-resorts, offering everything from fine dining to theme parks as they looked to attract more mass-market gamblers to compensate for the fall in high rollers.
MGM Cotai is the latest casino in the Chinese gambling enclave to push non-gaming attractions, offering a luxury spa and an art collection.
Some big spenders have also returned to the territory, with high rollers being the biggest drivers of revenue growth in 2017, Bloomberg News reported.
MGM China, a tie-up between Las Vegas-based MGM Resorts International and Pansy Ho, the daughter of Macau gambling tycoon Stanley Ho, went public in Hong Kong in 2011.
The elder Ho was credited with transforming Macau from a sleepy Portuguese outpost to a gaming boomtown.
Beijing is considering plans to allow gambling on Hainan island and end a long-standing ban in mainland China, according to reports this month, which would be a historic turnaround for the communist government.