Best selling romantic fiction novelist Paul Sheldon retires each winter to the snow-covered hills of Colorado to write another work featuring his beautiful herione Misery Chastain. Driving whilst inebriated, he encounters severe weather and his car goes off the road.

Instead of awakening in hospital he comes to in a filthy, dilapidated farmhouse, isolated from the outside world by the blizzard, occupied by the psychopathic Annie Wilkes, his "Number One Fan". She insists she will nurse him, refusing to tell anyone his whereabouts. His crushed legs mean he is virtually a prisoner, dependant on Annie for pain relief. When she discovers his new novel does not feature Misery she forces him to destroy the manuscript and write another.

Thus begins Paul's descent into a living hell. Annie withholds pain relief, inflicts humiliation and degradation, forcing Paul, like Scheherazade, to write a new chapter every day simply to stay alive.