I had the opportunity to see this show performed live in San Francisco back in 2002. The entire album was performed live with a band (two guitars, drums, bass, keyboard) playing the album all the way through as other cast members sang, danced, and acted out the story of the album. It's like a rock opera, in that the music is always playing, and all of the words in the piece are sung. It is not, however, acted out on stage as explicitly as a play or opera ordinarily would be; the movement of the characters is more symbolic than realistic. Besides the band, there were performers playing the parts of the mother, the schoolmaster, the wife, the manager, the doctor, Pink, and Pink's alter-ego. There were four background singers and a group of dancers who were deployed from time to time throughout the show.
Finally, there were the visual images, which were projected on a screen behind the stage, with the same video stream shown simultaneously on both of the side walls (leaving you surrounded or "walled in") which were absolutely stunning. John Jansen, who directed and edited the video, told me that he intentionally forewent the usage of any of the images from the movie or album, and instead created a stream of 1961-1989 images that bookend the creation and destruction of the Berlin Wall. Pink's father now dies in the Vietnam war and Pink's musical influences are from the late 60's and early 70's (complete with images of Pete Townshend smashing his guitar), leading up to Pink's own musical rise in the MTV 80's and finally his own self-destruction as the Berlin Wall is destroyed in 1989.
As cool as the on-stage show was, it wouldn't have been half the experience without the video. It was not like seeing projected images during a concert, in which the video and the music complement one another; this video was synchronized to the music -- not blatantly, but subtly -- so that what you were seeing and what you were hearing always worked together, though you'd frequently be at a loss to explain how or why. In fact, I went back and saw the show a second time to just watch the film.
Especially worthy of mention among the performers was Daniel Knop, who played Pink. He would take the stage, standing still, almost rigid, with one hand behind his back, then at just the right moment cut loose with an agonized scream that showed the torment that roiled inside of him. Whether sitting slumped over as the doctor and the manager tried to revive him during Comfortably Numb, or screaming at his wife in Don't Leave Me Now, he hit just the right mark.
One of the most unique and rewarding live experiences I've seen in San Fancisco.