Mthwakazi is known for her completely unique "Xho-pera" performances, which combine classical operatic vocals, exclusively in her native isiXhosa, with ancestral sounds from indigenous stringed bows and percussion instruments.

Mthwakazi's compositions shift back and forth through time, gathering elements of traditional African, choral and church music, jazz, funk and a range of genres. Contemporary instrumentation (keys, bass, brass) adds another layer, and she plays with a formation that ranges from a duo through to a full orchestra, or “Xhochestra”, depending on the occasion.