The play, a satire on American family life, concerns a married couple and their elderly mother. On a particular day, they are visited by two guests who turn their worlds upside down.

The central family consists of a Mommy, a domineering wife, Daddy, an emasculated and submissive husband, and Grandma, the half-senile mother of Mommy. The play opens with the three of them discussing Mommy's day around a pile of boxes. An honorary member of the community and idol to Mommy, Mrs. Barker, enters and the dialogue continues with the occasional interjection by Grandma. Mommy and Daddy exit, leaving Mrs. Barker and Grandma alone. Grandma apparently knows why Mrs. Barker has been asked to come by and explains to her that Mommy and Daddy had adopted a son from her many years previously. As the parents objected to the child's actions, they mutilated it as punishment, eventually killing it. After Mrs. Barker exits, a Young Man appears at the door, looking for work. After hearing his life story, Grandma realizes that this Young Man, whom she dubs "The American Dream," is the twin of Mommy and Daddy's first child. As the first child was mutilated, he too suffered pain and has been left as an empty shell of a man. After seeing this Young Man as a way out, she moves her things and leaves. The Young Man is introduced to the family as a suitable replacement for the original child. The play ends with Mommy and Daddy celebrating the Young Man's arrival, with Grandma already forgotten.

Albee explores not only the falsity of the American Dream but also the status quo of the American family. As he states in the preface to the play, "It is an examination of the American Scene, an attack on the substitution of artificial for real values in our society, a condemnation of complacency, cruelty, emasculation, and vacuity; it is a stand against the fiction that everything in this slipping land of ours is peachy-keen."

Press notes state: "It is a ferocious, uproarious attack on the substitution of artificial for real values, a startling tale of murder and morality that rocks middle-class ethics to their complacent foundations. In it, Albee explores the hollowness of the American dream, as well as the fallacy of the ideal American family