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 and Maura investigate a family's background when a man is killed; Jane suspects that Maura is hiding something.