The main places in Kamouraska are the titular town, Sorel, and Quebec City, which are all located in Canada’s Quebec Province. In addition, Burlington, Vermont, in the United States, also plays a significant role. Most of the novel’s action takes place in Kamouraska. The secondary setting of Sorel is important as the childhood home of the first-person narrator, Elisabeth Rolland. Although Anne Hébert’s novel opens in Quebec City, the plot is primarily concerned with events that happened elsewhere and long before Elisabeth begins her tale.

Kamouraska covers two marriages and an adulterous affair that Elisabeth had at different points in her life. She was raised in Sorel and temporarily returns there when she has serious problems in her first marriage to Antoine Tassy, which is what had taken her to live in Kamouraska. Sorel is also significant as the place where she meets and has the affair with George Nelson, an American doctor. After George carries out her plot to kill Antoine, the doctor-turned-murderer flees across the border to Burlington.