She was forced to cancel her tenth show after being ordered to rest by doctors.
But Madonna was on fine form as she finally returned to the stage at the London Palladium for the first date of her UK Madame X tour on Tuesday.
The pop icon, 61, appeared in high spirits as she left the venue in a long black and gold baroque personalised Versace coat.
Superstar: Madonna was on fine form as she finally returned to the stage at the London Palladium for the first date of her UK Madame X tour on Tuesday
The cosy coat, which came complete with a faux fur trim, featured a Madame X red embroidered symbol on the back in homage to her tour.
Madonna teamed the look with fishnet tights and black chunky shoes.
Styling her strawberry blonde locks in corkscrew curls and still sported her glamorous stage make-up.
Designer garb: The pop icon, 61, appeared in high spirits as she left the venue in a long black and gold baroque personalised Versace coat
Versace: The cosy coat, which came complete with a faux fur trim, featured a Madame X red embroidered symbol on the back in homage to her tour
She’s back! Tuesday night marked Madonna’s first Madame X gig in London after she pulled out of Monday night’s opening show due to injury – the tenth cancelled date of the world tour
Madonna was escorted out of the Palladium by a number of burly security men via the stage door.
The singer looked a little weary as she got into her chauffeur-driven taxi after completing the first of her stint of UK tour dates.
Tuesday night marked Madonna’s first Madame X gig in London after she pulled out of Monday night’s opening show due to injury – the tenth cancelled date of the world tour.
Time for bed: Madonna was escorted out of the Palladium by a number of burly security men via the stage door
Feeling the love: Madonna flashed a smile after her stage show
Back to her best: Madonna assured fans that she was ready to perform before the concert as she shared a sneak peek of rehearsals
Ill: Tuesday night marked Madonna’s first Madame X gig in London after she pulled out of Monday night’s opening show due to injury – the tenth cancelled date of the world tour
The singer told fans she was ‘deeply sorry’ but that she needed to ‘put her body and her health first’.
‘Under doctors guidance I have been told to rest for a few days,’ she wrote on Instagram.
‘As you all know, I have injuries that have plagued me since the beginning of the tour but I must always listen to my body.
Tough decision: The singer told fans she was ‘deeply sorry’ but that she needed to ‘put her body and her health first’
‘Please know that it hurts me more than you can imagine to have to cancel any shows.’ She also cancelled dates in New York, Miami Beach, Los Angeles, Boston, and Lisbon.
Madonna assured fans she was ready to perform before the concert as she shared a video of her daughter Estere drumming backstage with the all-female backing act Orquestra Batukadeiras, who are from Portugal, where the singer now lives.
Fans paid hundreds of pounds to get in as Madonna belatedly played the first of her UK dates.
Stage costume: Madonna teamed the look with fishnet tights and black chunky shoes
But those planning to record their presence on their phones were in for a disappointment.
The singer banned the use of mobiles and smart watches at her 14-night London Palladium residency, part of the Madame X world tour.
Instead concert-goers were forced to lock away their devices in special fabric cases as they entered.
Weary-eyed: The singer looked a little weary as she got into her chauffeur-driven taxi after completing the first of her stint of UK tour dates
This meant they could carry the phones but not use them until after the show when they swiped the case to deactivate the magnetic lock on their way out.
During the tour, Madonna has been taking one Polaroid per concert, which she auctions to an audience member, with the money going to her charity, Raising Malawi.
She implemented the phone ban from the start of the tour in New York in September.
No phones allowed! Madonna banned the use of mobiles and smart watches as part of her Madame X world tour
She is one of a number of artists moving towards phone-free gigs, with Alicia Keys and Guns N’ Roses previously using Yondr, the US firm hired by Madonna to ensure mobiles are locked away.
Kate Bush asked fans not to use their phones to record her comeback shows at Hammersmith Apollo in 2014. The reclusive singer said she wanted fans to ‘share in the experience together’.
Tickets for some London dates were still on sale last night for up to £511.50. Resale websites were demanding more than £700.
Wow: The singer, who implemented the phone ban from the start of the tour in New York in September, will hold her 14-night tour at the London Palladium