It tells the tale of Katurian, a fiction writer living in a police state, who is interrogated about the gruesome content of his short stories and their similarities to a number of bizarre child murders occurring in his town.

When he hears that his brother Michal has confessed to the murders and implicated Katurian, he resigns himself to being executed but attempts to save his stories from destruction.

In his own narrative, Katurian describes being raised by loving parents who encouraged him to write, and for many years he wrote very happy stories.

At Michal's request, Katurian tells him the story of "The Pillowman", about a man made of pillows who convinces children to kill themselves so they can be spared a horrible future.

Katurian lulls Michal to sleep by telling him one of his happier stories, "The Little Green Pig", then smothers him to save him the pain of being executed.

The Pillowman stemmed in part from McDonagh's experience composing fairy tales, with names such as "The Chair and the Wolfboy", "The Short Fellow and the Strange Frog", and "The Violin and the Drunken Angel", early in his writing career.

In a conversation with Irish drama critic Fintan O'Toole in BOMB Magazine in 1998, McDonagh retold the Brothers Grimm version of Little Red Riding Hood.

[4] The play received its first public reading in an early version at the Finborough Theatre, London, in 1995 in a season that included Shopping and Fucking by Mark Ravenhill.

The original production starred David Tennant as Katurian, Jim Broadbent as Tupolski, Nigel Lindsay as Ariel and Adam Godley as Michal [6] The play opened on Broadway on 10 April 2005 at the Booth Theatre and closed on 18 September 2005.

Directed by John Crowley, the cast included Billy Crudup as Katurian, Michael Stuhlbarg as Michal, and Jeff Goldblum as Tupolski.

[7] The play was revived from 10 June 2023 to 2 September 2023 at the Duke of York's Theatre in London's West End, directed by Matthew Dunster.