The tension between the Kennedy and Johnson factions, the worldwide reaction, and Lee Harvey Oswald's televised murder by Jack Ruby are discussed in painstaking detail.

Working 100 hours a week for two years to meet an accelerated 1967 publishing deadline, the stress of producing the book sent Manchester to a hospital due to nervous exhaustion for more than two months, where he completed a manuscript of 1,201 pages and 380,000 words.

[2] Manchester gave the manuscript to his editor at Harper & Row, Evan Thomas, and to the Kennedy family for review during March 1966.

They believed that passages in the book "unflattering" to Johnson might damage Robert Kennedy's political plans for 1968, and requested changes.

She claimed that her interviews with Manchester had been intended for the library, threatened to block publication of the book unless the changes were made, unsuccessfully offered Look $1 million to cancel the serialization, and during late 1966, filed a lawsuit asking the court to issue an injunction to stop the book's publication.

Through an out-of-court settlement during January 1967, Manchester agreed to delete 1,600 words from the serialization and seven out of 654 pages from the published book.

Although headlines noted Jacqueline Kennedy as the victor, Manchester claimed that the deletions were "harmless", and retained the serialization fee.