Detective Jane Rizzoli and medical examiner Maura Isles investigate the grisly murder of a wealthy couple. The M.O. matches the work of a serial killer known as the Surgeon, who once nearly murdered Jane. Now that the Surgeon is behind bars, it seems one of his proteges is picking up where he left off.

Jane and Maura investigate the mysterious death of a young boy whose family is from Cape Verde. It appears at first that he may have died during an attempted exorcism, and it may take a message from beyond the grave for Jane to pinpoint exactly what happened. Jane is distracted from the case when her mother sets her up on a surprise date.