As a performer, he plays concerts as soloist, in chamber music ensembles, in orchestras, and with different choirs in several venues in Europe and the US with a vast repertoire spanning from Frescobaldi to contemporary composers. In May 2020 he recorded the complete set of Etudes Op. 23 by the contemporary Italian composer Giovanni Albini. Matteo Generani is currently devolving great effort in the research, revival, and study of Giuseppe Martucci’s output (Martucci Research). In December 2024, it will be released Matteo's CD on Martucci Solo Piano Works with the Naxos Recording Label.

In conjunction with performing, Matteo Generani is also passionate about teaching. He worked as a piano instructor for the Cultural Association Tetracordo, and the Ricordi Music School, Opera–Milan in Italy, he taught piano group classes at Central Michigan University, and as one of the piano faculty at the University of Missouri–Kansas City (UMKC) Conservatory Academy.

Matteo Generani is also interested in outreach initiatives. He actively participated in the “Emerald Coast Music Alliance Festival” and “Music for All,” two outreach programs that brings exposure of world-class classical music performances to populations who would otherwise not have access to such. Matteo is also co-artistic director of Classical Music Express.

Matteo frequently performs in chamber music ensembles and collaborates often with singers. 

He is the co-founder of the Medhelan Duo and the Neo-Art Piano Duo.