[1] An unnamed male narrator is working at a power plant but due to a carpenter's strike, finds himself forced to spend a winter in the nearby small town of (fictional) Starkfield, Massachusetts.

The young Frome is married to a sickly woman named Zeena (Zenobia), who appears older than her age, is unkind to Ethan, and whose life revolves around seeking expensive treatments for her varied illnesses.

Ethan, miserable at the thought of losing Mattie, considers running away with her, but he lacks the money to do so, and will feel guilty about leaving Zeena with the farm.

The next morning, Ethan rushes into town to try to get a cash advance from a customer for a load of lumber in order to have the money with which to elope with Mattie.

After their first run, Mattie suggests a suicide pact: that they go down again, and steer the sled directly into a big elm tree, so they will never be parted and so that they may spend their last moments together.

[3] Wharton found the notion of the tragic sledding crash to be irresistible as a potential extended metaphor for the wrongdoings of a secret love affair.

The connection between land and people is very much a part of naturalism; the environment is a powerful shaper of man's fate, and the novel dwells insistently on the cruelty of Starkfield's winters.

"[5] Wharton was able to write an appealing book and separate it from her other works, where her characters in Ethan Frome are not of the elite upper class.

She found a story that functions as a "realistic social criticism," a reminder that some are willing to indulge in dull prose based solely upon the name of the author.

[7] The book was adapted to the 1993 film of the same name, directed by John Madden, and starring Liam Neeson, Patricia Arquette, Joan Allen and Tate Donovan.

The ballet premiered in 2018, with Ulrik Birkkjaer as Ethan, Sarah Van Patten as Zeena and Mathilde Froustey as Mattie.