Detective Jane Rizzoli and medical examiner Maura Isles investigate the grisly murder of a wealthy couple. The M.O. matches the work of a serial killer known as the Surgeon, who once nearly murdered Jane. Now that the Surgeon is behind bars, it seems one of his proteges is picking up where he left off.

Jane was once abducted and neared killed by imprisoned serial killer Charles Hoyt. Now a body found in a park has all the indications of being his work. Jane must do her best to keep her fear of this man in check while Maura attempts to get inside the mind of the killer.

A serial killer claims to have clues about the murder of another prisoner; Frankie Jr. prepares to take the detectives exam.

When Jane and Maura are asked to present the case of serial killer Charles Hoyt at a symposium for law enforcement, Jane worries that her greatest challenge will be facing bad memories. However, as she and Maura begin a simulation of investigating Hoyt’s murders, they soon come across a horrifying discovery. In a matter of moments, the team finds themselves drawn into a lethal game of cat and mouse with a new and terrifying serial killer.