Squad 51 C-shift paramedics rescue a stuntman from a tower. Johnny and Roy respond to treat the injured child of a fireman's widow. A small plane and a chartered jetliner collide in midair, landing in a residential neighborhood, trapping Johnny and Roy. Station 18 leads a massive response from Battalion 14 and the Compton Fire Department. Dr. Morton heads up a triage team from Rampart. Multiple rescues include passengers from both planes and people in the subdivision. Dixie and Dr. Early perform brain surgery on the injured child. An elderly man's dog leads Chief McConnike to its owner. This movie marks the last appearance of the Squad 51 vehicle, as it is apparently buried in, and destroyed by, debris from the plane crash.

When John Gage and Roy DeSoto are both promoted to Captain, they reminisce about their years working together, along with Dixie and Dr. Early, at Rampart. Flash-back sequences include the rescue of airplane passengers after a crash-landing, a potential suicide threatening to leap from a crane tower, and a girl whose toe is stuck in a faucet.