The book chronicles the final year in the life of the title character, Ricardo Reis, one of the many heteronyms used by the Portuguese writer Fernando Pessoa.

While there, he chooses not to resume practicing medicine, but rather takes up residence in a hotel, where he wastes his days reading newspapers and wandering the streets of Lisbon.

Fernando Pessoa had created the character of Ricardo Reis fifty years or so prior to its release, giving him a biography and writing many poems under that name.

Reis spends much of his time reading a novel called The God of the Labyrinth, a fictional novel mentioned by the writer Jorge Luis Borges and attributed to the title character of his short story "An Examination of the Work of Herbert Quain".

The Year of the Death of Ricardo Reis is written in Saramago's distinctive style, which disregards the traditional use of punctuation, except for commas and periods, and which denotes dialogue and changes in the speaker using only capital letters.