According to Ann Saddlemyer in her book Becoming George: The Life of Mrs. W. B. Yeats (2002), the poet is partially based on W. B. Yeats, and his wife "George" (Georgie Hyde-Lees) was the inspiration for both the secretary and the woman with visions.

[2] Robert Henderson has summarised the thesis of the opera as follows: Elegy for Young Lovers... is a bitter indictment of the Romantic notion of the artist as hero, feeding remorselessly on those around him both in the name of art and to satisfy his own monstrous and inhumanely egotistical appetites.

The opera is set in an inn called Der Schwarze Adler in the Austrian Alps in 1910.

The plot is centred on a poet, Gregor Mittenhofer, who manipulates the people in the inn to provide inspiration to his work, his faithful secretary, his doctor, his young "muse" Elisabeth and a hysterical woman who lost her husband to the mountains decades before and has visions.

[6][7] When a young man arrives who attracts Elisabeth, Mittenhofer lets her go but does not act to prevent the young lovers' death in a snowstorm in the mountains, using the tragedy as the inspiration for a final "Elegie" of pure music, sung without words.