Carlos and Gabrielle decide to adopt, but the process comes to be a lot more difficult than either had expected. Susan finally has her surgery as she finally has medical insurance. Meanwhile, a showdown between Bree and her son Andrew lead to a full out war between mother and son. Also, a dying Noah Taylor learns more about Paul Young and his biological grandson Zach. Lastly, Tom is having more difficulty at the job when having to take orders from his boss and wife Lynette.

Susan offers to help the father of Julie's baby raise the child; Bree agrees to go to Maine with Orson - perhaps for good; Karen pleads with Gaby not to tell Roy about her condition; and the loan shark who threatened Ben sets out to ruin Renee.

Bree is not so sure about Andrew's upcoming marriage; Gabrielle tries to find work in an employment agency in order to teach Carlos and the kids a lesson; Lynette plans to win back Tom at any cost; Susan's parenting skills concern Julie; Ben asks Renee to marry him.