J.D. Vance begins his book by presenting the reason why he wanted to write it in the first place. Vance distinguishes himself as a man who came from a poor family and who, despite the odds, managed to get a degree from a prestigious law school. Vance comes from a family of Scots-Irish immigrants and hailed from a poor part of Kentucky, where drug abuse and poverty were common. Despite this, Vance claims that the hillbillies are in part to blame for their own situation since they believe they are largely powerless to do anything to change it.
In the first chapter, Vance describes his family and childhood. Vance moved a lot as a child but he always felt close to Jackson, Kentucky, where he spent his summer days with his grandmother. Vance was abandoned by his father at a young age and notes that his mother dated many men, but none of them stayed for too much time. Because of this instability in his eventual Ohio hometown, Vance always felt safe in Kentucky, the place where his grandparents and family's roots remained. Vance remembers stories his uncles told him: tales about how they protected their family values even though it sometimes meant using violence.
Vance mourns for his Ohio hometown, as it has suffered a decline as a result of widespread poverty. Instead of trying to solve the problem, the people in the city lost faith in their ability to control that which was occurring around them and allowed the place to decay both physically and emotionally.
In the second chapter, Vance talks about his grandparents. Vance’s grandparents, Mamaw and Papaw, were childhood friends and had their first child when Mamaw was 13. The two moved from their hometown because they were afraid of how their families would react, and Papaw found a job in Ohio at a steel plant. They did return home from time to time despite being criticized by their families for running away. In Ohio, they likewise looked at with contempt by their more conventional neighbors, who did not trust them because they were "hillbillies." The two also had problems integrating and finding their place in the small community. The two managed to escape poverty and achieve economic stability, moving into a bigger house when their children grew older.
After the couple had three children, they began having marital problems. Papaw began drinking and Mamaw warned him that she would kill him if she ever caught him drunk. She made good on this promise, once attempting to set Papaw on fire.
Their first child, Jimmy, left home at 18 and found a good job. Their second child, Lori, married an abusive husband whom she later divorced. Their youngest, Bev (the author's mother), got pregnant at 19 and gave birth to a daughter. She later became a single mother, divorcing her abusive husband.
Vance notes that his grandparents eventually reconciled and became an example to him. They also helped their children through tough times and urged their daughters to leave their abusive husbands.
Vance later introduces the company that provided a safety net to people like his grandfather: Armco Steel. Vance notes that while factory towns encourage their citizens to have a good life, they also encourage complacency. Often, children in factory towns grow up depending on the idea that they will have a job at the factory, and thus do not aspire to go to college.
Luckily, Vance received an alternate education at home. Even though his grandparents and mother were not exceptionally intelligent, they made sure to push Vance in the right direction and to assure him that he can do anything if he is willing to work for it.
Vance’s mother remarried, to a man named Bob. The couple moved from Middletown and then shortly began fighting with one another. Things became violent, and Vance regularly broke up fights between his mother and adoptive father. Bob asked for a divorce when he found that Bev was cheating on him. Bev tried to kill herself after the incident, and Mamaw convinced her to move back to Middletown so she could help raise Vance and his sister, Lindsay.
Unfortunately, Bev's bad choices, which often included staying up late to drink and yelling at her children, led to a tense family dynamic. She even tried to kill Vance, but a woman called the police and Bev was arrested. After that, Vance began spending more time at his grandmother's home.
Vance also contacted his biological father and was surprised to find that he was nothing like his mother had described him; he was instead a religious family man with a loving wife and children. His father also introduces Vance to his Christian faith, allowing Vance to see how religion could help people make good choices when times are tough. Unfortunately, his father's Christian faith also discourages Vance from believing he can be himself.
When Vance was 13, Papaw died; soon after, Vance found that his mother was addicted to prescription pills. Bev eventually went to rehab, and Vance and his sister Lindsay remained alone to fend for themselves.
After finishing eighth grade, Bev tried to convince Vance to move to another city so she could move in with her boyfriend. Vance refused and went to live with his father instead. Weeks later, Vance called his sister to come and get him, discouraged by the pressures of his father's devout Christianity. To escape, he moved in with Mamaw. When school started, Vance moved back to his mother's house, as she planned to marry once more. This time, the man’s name was Ken, and he was Bev’s boss. Unfortunately, Vance did not get along with Ken’s children, so Vance began sleeping at Mamaw’s from time to time.
Around the same time, Vance began smoking pot, and his mother began using drugs again. After Mamaw found out about Bev’s drug use, she told Bev that from that day on, Vance would be staying with her full-time. After moving in with Mamaw, Vance’s life began improving and he started focusing on his school again.
Around the same time, Vance began reading about sociological problems and the factors that might be contributing to the decline of his community. Sensing that he was not independent or motivated enough to go to college right after high school, Vance decided to join the Marines. Vance was sent to boot camp, but he visited Mamaw as often as he could. In 2005, after finishing his training, Vance was to be deployed to Iraq. Before going to Iraq, however, Mamaw died from a collapsed lung stemming from emphysema.
Vance went to Iraq, where he worked for two years. After Vance returned from Iraq, he decided to go to college and began attending Ohio State University, where he graduated in one year and eleven months. During his time there, Vance worked several jobs to sustain himself. He then moved back to Middletown where Vance worked to make money to go to law school.
Vance was accepted into Yale, where he had a hard time adjusting mainly because he was unsure where he fit in, but also because the teachers looked down on him for not having graduated from a prestigious college. Vance fell in love with a woman named Usha, who helped him navigate his newfound upper-crust lifestyle, along with one of his professors and mentors, Amy Chua. Vance gradually learned to open up about his life, confront his anger issues, and gain the social capital he needed to succeed.
After finishing college, Vance married Usha. Around the same time, Vance found out that his mother had begun using drugs again. Instead of abandoning her, however, Vance decided to help her when he could.
Vance ends his book by describing how much he has changed as a result of his Mamaw's positive influence, and how he hopes to better himself every day by learning to control his inherited temper, give children from backgrounds like his a leg up, and by being a model they can follow.
