This story begins with Ruby Turpin and her husband, Claud, arriving in a doctor's waiting room because Claud has been kicked by a cow and has an ulcer on his leg. Also in the waiting room are a "stringy" old man, a well-dressed older lady, and a dirty-looking child. Mrs. Turpin is irritated that the child does not move to let her sit down, as would be polite. Mrs. Turpin feels an affinity with the "stylish" white lady and chats with her.

Meanwhile, a fat teenage white girl with acne is silently reading. Mrs. Turpin judges her, thinking that she is ugly. With the girl is an older woman Mrs. Turpin thinks is "white trashy." Mrs. Turpin casually thinks to herself that these people are "worse than n*****s," noticing, in particular, their shoes. At night, when Mrs. Turpin is trying to sleep, she often ranks people according to their levels of righteousness, ranking "white trash" and Black people at the bottom and others above them. Every person's ranking is based upon their wealth and social standing. Mrs. Turpin is extremely grateful to have been born as she is: a God-fearing, middle-class white woman.

Mrs. Turpin begins to express these views to the others in the waiting room. When discussing the "nice clock," Mrs. Turpin cannot resist saying she has a clock like that, and she judges the poorer white people for mentioning "green stamps." As the conversation goes on, Mrs. Turpin feels the teenage girl looking at her, increasingly hostile. The women talk about sending Black people "back to Africa" and complain about cotton picking machines. Eventually, the conversation turns to Black people marrying white people, looking to "improve their color."

Soon Mrs. Turpin addresses the mother of the teenage girl, Mary Grace, and finds that Mary Grace is in college. The girl does not speak, and Mrs. Turpin judges her for her lack of manners. She then thinks that she would rather send the "white trash" to Africa than send the "n*****s." At length, Mrs. Turpin says that she is flooded with gratitude every day for being who she is ("Thank you Jesus!").

At this point, Mary Grace has had enough. She throws a book at Mrs. Turpin and tells her she is "a hog from hell." Mary Grace is sedated and taken to the hospital, and Mrs. Turpin, outraged, goes home with her husband.

Mrs. Turpin cannot understand why the girl would say such a thing to her. She thinks of all the other people who are more "hog"-like than she is. She even tells her Black servants what was said but is then offended by their resultant flattery, thinking it insincere. At length, she goes out to look at the hogs and interrogates them. It seems that she is really interrogating God—"What do you send me a message like that for?"

At the end of the story comes Mrs. Turpin's "revelation." As in a vision, she sees a "vast swinging bridge" going up to heaven. On it, "white trash" and Black people are ascending, while judgmental middle-class people (like herself) are having their virtues "burned away." Finally, Mrs. Turpin realizes that she has been wrong in her understanding of what a Christian really is; her eyes have been opened, and she hears "the voices of the souls climbing upward . . . and shouting hallelujah."