Lorenzo Alcazar came to Port Charles, New York, in the summer of 2003, following the death of his brother. Immediately, he blamed the death on Sonny Corinthos (though it was Alexis Davis who had pushed Luis to his death), and the feud between the two men began.

After learning that Ric Lansing had kidnapped Carly and was keeping her chained to a wall in the panic room of his home, Lorenzo came up with a perfect plan. He would rescue the pregnant Mrs. Corinthos from Ric, but keep continue to keep her away from Sonny. The longer he spent alone with Carly on his yacht, the deeper the feelings Lorenzo began to experience for her. He eventually allowed her to return, unharmed, to her husband and son.

When Sonny’s sister, Courtney, snuck aboard his yacht while Alcazar was traveling to South America, Lorenzo took her hostage. He planned to trade her for Carly, but never got the chance. She jumped overboard to escape him, losing her unborn child in the fall.

An unlikely friendship had blossomed between Lorenzo and Carly while he had held her on his yacht. This friendship led to Lorenzo checking on Carly the night of a storm. It was good luck for Carly---she has fallen down her stairs and gone into labor. Knowing there was no way to get her to General Hospital in time, Lorenzo agreed to help her with the delivery. Unfortunately, Sonny walked in as Carly was screaming. Assuming that Alcazar was hurting his wife, Sonny pulled out his gun and shot. The bullet went through Alcazar and lodged in Carly’s brain. Both Carly and the baby, Morgan, survived the ordeal.

As Carly recovered from the gunshot wound, Alcazar was the only one she responded to. He knew that, and it only made his love for her stronger. He became determined to win her away from Sonny. When Carly came to him one night, after seeing Sonny and Sam in bed, he was more than happy to make love to her.

Though she didn’t want to admit it, Carly was falling for Lorenzo as well. After his niece was killed by Mary Bishop (who had mistaken Sage Alcazar for Emily Quartermaine), Lorenzo retaliated by killing her. He was arrested for the crime, but Carly changed the evidence so no one could prove he had done it. Carly also helped Lorenzo to deal with the news that he had a teenage son, Diego, whom he had never known about.

When Carly’s boys were kidnapped by Faith Roscoe, Lorenzo was her support. He assisted both financially and physically in the church, yet was still fingered as a suspected accomplice. Neither Carly nor Diego doubted his innocence.

After the children were returned, Lorenzo swept Carly off to South America, were they were married. The marriage was not a happy one, though. He loved Carly, but could not be sure that she was truly over Sonny. The night she ran to Sonny, after learning the truth about Reese’s reasons for being in Port Charles, Alcazar packed her bags and told her to leave his house.

Somewhere along the line, he formed a friendship with Skye Quartermaine. As the friendship deepened, Skye was able to help Lorenzo move beyond his love for Carly. When the virus hit Port Charles, Skye grew deathly ill. Lorenzo was prepared to do anything to help her, including switching her chart with a more severely ill patient. He ensured that Skye received a dose of the antidote rather than Lulu, who was close to death. He did feel guilty about this, but felt justified when Skye recovered and learned she was pregnant with his child. Though she left Port Charles, with the help of Robert Scorpio, Lorenzo was able to track Skye down in time to help deliver their daughter, Lila Rae.

In order to protect little Lila Rae, Lorenzo decided to leave behind all mob activities. He was planning “one last job”. This job involved the delivery of a brief case with unknown contents to Mr. Craig. He left this brief case locked securely in the vault of the Metro Court Hotel. He went to Sonny’s coffee house, planning to shoot Sonny to keep him from interfering. Instead, Sonny shot him in the head. The injury left him unable to make the delivery on time, which in turn led to the Metro Court hostage crises.

Currently, Lorenzo Alcazar is allowing Skye to run his business while he recovers.