The Lyttleton stage is ink black except for three fire escapes which are suspended from the flies and as the auditorium lights go down they rotate to make way as a tiny bed-sit apartment set slides into view.
This is the home of Jackie (Ricardo Chavira) and his girlfriend Veronica (Flor De Liz Perez).
Jackie has just got out of prison, is off drugs and alcohol and has managed to secure a job. He's with the woman he's loved since school and things are looking up except he's just spotted a hat that doesn't belong to him in their apartment.
The discovery sparks suspicion and threatens to undo everything that Jackie has achieved to date but his isn't the only life that could unravel.
He retreats to his sponsor Ralph (Alec Newman) who is having his own relationship problems with his wife Victoria (Nathalie Armin), a recovering drug addict.
The skill in the staging of this play is in making the sets look claustrophobic on the vast Lyttleton Stage. There is an ethereal quality as that of Jackie's apartment, Ralph's and his cousin Julio's (Yul Vázquez) drift into view from out of the darkness.
It is incongruous to the high tension of what is unfolding on stage almost like the pauses between rounds of a boxing match or rather something dirtier, a cage fight perhaps.
It's the sort of thing I can imagine them writing were they still with us today.
Guirgis has a brilliant ear for the vernacular and a keen observation of human behaviour.
Jackie is like a 21st century Eddie Carbone and Stanley Kowalski with a background of drugs and tough street love.
The tension is in Jackie's fight against self-destruction as infidelity threatens the life he wants to have with Veronica.
Relationships and friendships, loyalty and love are all tested and examined with both passion and humour - there are plenty of laughs in this.
Yul Vásquez is a bit of a scene stealer as Cousin Julio, an unexpectedly sage voice amid the turmoil.
In the end, it is the final note, an emotional punch after the high energy roller coaster ride of a play that leaves an indelible mark.
I've not seen any Guirgis' plays before. He won a Pulitzer for Between Riverside and Crazy and after seeing The Motherfucker with the Hat I'm hoping more of his work will make its way onto a London stage.
Go and see The Motherfucker with the Hat, it is one hour and 45 minutes long and is on until August 20.