The Grand Lisboa's profile is deliberate and layered with meaning. The lower globe structure is meant to evoke a lotus flower — the symbol of Macau — while the tower rising from it suggests an egg, a form associated in Chinese tradition with new life and fortune. Together they create a silhouette that is instantly recognizable from across the Pearl River Delta. The interiors, designed by Khuan Chew of KCA International, extend the ambition outward: the casino floor offers 800 gaming tables and 1,000 slot machines, making it one of the largest gaming operations in the world. The hotel portion, which opened in December 2008, contains 430 rooms and suites in the tower above. Nothing about it is accidental or restrained.

The Grand Lisboa opened its casino and restaurants on 11 February 2007, and it brought a few notable firsts to Macau's gaming culture. It was the first casino in the territory to offer Texas hold 'em poker ring games, and the first to offer craps — games more associated with Las Vegas that had not previously found a home in Macau's baccarat-dominant casino landscape. Both have since spread to other properties in the city. The building is owned and operated by Sociedade de Jogos de Macau, the gaming company founded by Stanley Ho, whose family controlled Macau's gambling monopoly for decades before it was broken open to international competition in 2002. The Grand Lisboa was SJM's answer to the challenge from Cotai's mega-resorts.

Two attractions in the Grand Lisboa operate at different ends of the experiential spectrum, and both are exceptional. In the casino, on permanent display, is the Star of Stanley Ho: a 218.08-carat cushion-shaped diamond that the Gemological Institute of America has certified as the largest cushion-shaped internally flawless D-color diamond in the world. It sits in a case, extraordinary in its clarity and size, available for anyone walking through the gaming floor to see. Eight floors up, at the top of the dome, Robuchon au Dôme occupies the building's crown. The late chef Joël Robuchon opened the restaurant in 2007; it earned three Michelin stars in 2008. Its wine list, comprising over 14,600 selections, has received the Wine Spectator Grand Award. In January 2013, the Miele Guide named it the top restaurant in Asia.

One of the most striking ways to see the Grand Lisboa is not from street level but from the cannon-lined ramparts of the Fortaleza do Monte, the seventeenth-century Portuguese fort that sits on Mount Hill in the center of the peninsula. From there, the juxtaposition is stark: colonial-era stone walls and replica 1860 cannon in the foreground, and rising just to the south, 261 metres of glass and gold. The photograph of that view has become one of Macau's iconic images — the layers of the city compressed into a single frame. The Grand Lisboa is the tallest building in Macau. It is also, in that image, a kind of answer to the question of what Macau has become: a place that has held onto its history while building something entirely new on top of it.