[1] The novel's narrative is based on the relationship of its two main characters – the romance novelist Paul Sheldon and his deranged self-proclaimed number one fan Annie Wilkes.

The novel, which took fourth place in the 1987 bestseller list, was adapted into an Academy Award-winning film directed by Rob Reiner, in 1990, and into a theatrical production starring Laurie Metcalf and Bruce Willis in 2015.

Paul Sheldon is the author of the best-selling series of Victorian-era romance novels featuring the character Misery Chastain, which he privately disdains.

After completing the manuscript for his new crime novel, Fast Cars, which he hopes will receive serious literary acclaim and kickstart his post-Misery career, Paul gets drunk and impulsively drives towards Los Angeles instead of flying back home to New York City.

Paul assesses that Annie is mentally unstable: she is prone to trailing off into catatonic episodes and has sudden, unpredictable bouts of rage.

Biding his time and likening himself to Scheherezade, Paul begins a new book, Misery's Return, and allows Annie to read the work in progress and fill in the missing N's.

He discovers a scrapbook full of newspaper clippings about deaths that reveal Annie to be a serial killer; her victims include a neighboring family, her own father, her roommate, and, while she worked as a head nurse, many elderly or critically injured patients and eleven infants, the last resulting in her standing trial but being acquitted in Denver.

When Annie discovers that Paul has been leaving his room, she punishes him by cutting off his foot with an axe and cauterizing his ankle with a blowtorch, "hobbling" him.

After he complains that more typewriter keys have broken and refuses to tell Annie how the novel ends before he has written it, she cuts off his thumb with an electric knife.

Paul resists the suggestion to write a nonfiction account of his own experiences, partly in the belief that he would inevitably embellish events.

Paul Sheldon turned out to be a good deal more resourceful than I initially thought, and his efforts to play Scheherazade and save his life gave me a chance to say some things about the redemptive power of writing that I had long felt but never articulated.

Annie also turned out to be more complex than I'd first imagined her, and she was great fun to write about ..."[8]The novel was adapted into a film in 1990, directed by Rob Reiner and written by William Goldman.

James Caan and Kathy Bates starred as Paul Sheldon and Annie Wilkes, with Lauren Bacall, Richard Farnsworth and Frances Sternhagen in supporting roles.

The play premiered in London at the Criterion Theater in December 1992, starring Sharon Gless and Bill Paterson and directed by Moore.

[15][16] The play, directed by Alan Cohen, was revived in 2005 at the King's Head Theatre in London, starring Michael Praed and Susan Penhaligon.

[18] A different play written by William Goldman (who also wrote the film's screenplay) and directed by Will Frears opened on Broadway in 2015 for a limited engagement.

The play was directed by Antti Mikkola and starring Esa Latva-Äijö as Paul Sheldon and Mari Turunen as Annie Wilkes.

The program was produced by Dirk Maggs, directed by Marion Nancarrow and starred Nicholas Farrell as Paul Sheldon and Miriam Margolyes as Annie Wilkes.