King Hedley II is part of August Wilson's Pittsburgh Cycle and takes place in the Hill District of Pittsburgh, Pennsylvania in 1985. The play can be read along with the earlier Seven Guitars and some of the characters overlap. The eponymous King Hedley II is the son of Ruby, a blues singer, and King Hedley (from Seven Guitars) although the precise identity of King Hedley II's biological father is at first unknown. King Hedley II is an ex-convict and urgently needs to earn ten thousand dollars in order to open a video store. However, he attempts to make this money by dishonest means, selling stolen refrigerators.

In the opening scene we are introduced to the primary cast of characters (King, Ruby, Tonya, Mister, and Stool Pigeon) and learn that King, Ruby, and Tonya live together. King starts to plant some seeds because he wants to grow flowers for Tonya, who is pregnant. King and his friend Mister squabble over money and we learn that King is selling stolen refrigerators. Toward the end of the scene, we see a fight between King and Tonya because Tonya tried to procure an abortion. In the third scene, we learn that Elmore has loved Ruby for a long time and we see the possibility of a relationship between them. King is bitter because he is unable to find a job, something he attributes to being African American. In the fourth and final scene of the first act, King and Ruby argue about money and Elmore buys a refrigerator from King—it turns out that he buys it as a present for Ruby.

The second act opens with Stool Pigeon burying the black cat that belonged to Aunt Ester, who has also died recently. He then presents King with a rusty old machete. In the second scene, Stool Pigeon is mugged, robbed of sixty-three dollars, and beaten up as well. We also learn that King's real father is a man called Leroy, even though Ruby allowed Hedley to believe that he was the father. Hedley commits murder with the machete that Stool Pigeon had presented King with. In the next scene, Ruby gets a gun from Mister because there's been a spate, in their neighborhood, of old women being beaten. King and Tonya continue to argue about the baby and Tonya says that she will only consider keeping it if King will eschew his criminal ways since she doesn't want the baby to grow up without a father. In the fourth scene, Mister is finally evicted, and Ruby and Elmore get married. Elmore shocks King by revealing to him that Leroy was his father. We learn, too, that it was Elmore who had killed Leroy decades ago. In the final scene of the play, King returns with his machete and begins a dangerous game of craps with Elmore. Even though King has a gun, he fires it into the ground instead of Elmore; fearing that Elmore would hurt King, Ruby attempts to shoot him but shoots her son instead.