Blood Fever begins with a prologue during which a young girl named Amy Goodenough is aboard her father's yacht in the middle of the Mediterranean sea when it is boarded by a band of pirates under the command of Zoltan the Magyar.

When Amy fails to get revenge by throwing a knife at Zoltan and hitting him in the shoulder, she is taken prisoner but swears she will one day succeed in achieving vengeance.

Following the events of SilverFin, James Bond is back at Eton where he is now a member of a secret risk-taking club known as the Danger Society.

As summer holidays approach, James is given the opportunity to go to Sardinia on a field trip with one of his professors, Peter Haight and a colleague, Cooper-ffrench.

Once arriving in Sardinia, James and his classmates begin a tour of the country to learn its history, during which Bond is poisoned (though the reader is not aware of it at the time) and almost killed.