The novel opens with a disembodied voice speaking a garbled version of the words, "Your number one fan" (3).

The novel's protagonist, Paul Sheldon, awakes in pain, completely disoriented. He begins to think back to his childhood and going to the beach with his family. Italicized words, indicating speech, interrupt his memories. Paul has a hazy recollection of how he came to be lying in utter pain, unable to breathe.

He feels a woman's mouth over his, performing CPR. Paul thinks the woman's breath stinks like a mix of desert and "chicken gravy" (5) and he forces himself to breathe on his own just so she'll stop breathing into his mouth. After this, he sinks back into a deep sleep.

When he regains consciousness, Paul realizes he's on a bed with a woman sitting beside him. She holds a book in her hands and Paul recognizes the author's name as his own. He asks her where he is, and she replies that they're in Sidewinder, Colorado. The woman introduces herself as Annie Wilkes, and Paul finishes her sentence: "My number-one fan" (6). Annie confirms this, smiling.