Bastard Out of Carolina spans the life of a young girl named Ruth Anne, but dubbed Bone when an uncle speculated that the new baby was, “no bigger than a knucklebone.” The book focuses on Bone’s life from the age of five through thirteen.

The story takes place in Greenville County, South Carolina, and centers around the Boatwright family: Granny, Anney, Raylene, Alma, Ruth, Earle, Beau, and Nevil. They are dirt-poor, hard drinkers, fiercely loyal to one another, and known for their quick, violent tempers.

Anney is Bone’s 16-year old unwed mother. Bone is born after a car accident initiates an early labor. Because Anney is unconscious after the birth, and because her family can’t name the father of the child, Bone’s birth certificate is issued with the word “Illegitimate” stamped across the bottom in large red letters. Anney spends years trying to get the offending word removed but with no success.

At 17, Anney marries Lyle Parsons and gets pregnant almost at once. They are happy together and Lyle vows to adopt Bone. Unfortunately, Lyle is killed in a car accident. Anney is left with two small girls she cares for by working as a waitress at the White Horse Café.

Glen Waddell enters Anney’s life a few years later. The black sheep of the Waddell family, he woes and wins Anney with his persistence, his interest in her girls, and his open devotion to her. As a side incident during this time, the courthouse burns to the ground and Anney celebrates by burning Bone’s birth certificate.

Anney gets pregnant again, and the night she goes to the hospital, Glen begins to show his true colors. He molests Bone while they sit in the car waiting for the new baby to be born. While she isn’t sure what has taken place, she knows it hurt and made her feel bad. Anney loses the baby, a boy, and is told she can never have more children.

Glen seems to decline from that point; he goes through a number of unimpressive jobs, they move constantly to stay ahead of bill collectors, and Anney has to go back to work to help supplement the family income. Glen continues to touch Bone when Anney isn’t around. Bone never says anything about Glen’s behavior because she is ashamed of it and blames herself for what is happening.

Bone begins to hate herself, her life, and many of the people in her life. She has no self-esteem which leads her to befriend Shannon Pearl— probably the only person in the town with less self-esteem than Bone. They spend a good deal of time together, but after a major falling out, Bone severs all ties with Shannon. Shannon finally calls and begs her to join them for a barbeque. Bone is horrified when Shannon is killed while adding fuel to the charcoal grill. It is Bone’s first real encounter with death and she spends a lot of time speculating what her death will be like.

The relationship between Bone and Glen is deteriorating. His self-loathing, fueled by his relationship with his father and brothers, and his inability to keep a job drives him to strike out at Bone. The smallest things set him off and he vents by abusing Bone. While Anney fights with him about the beatings, he always justifies them and Anney accepts his excuses. Bone interprets this as Anney taking his side and that feeds her own feelings of inadequacy and anger.

When one of the beatings puts Bone in the hospital, Anney sends Bone to stay with her aunts—both to keep her out of Glen’s way, and to give her time to heal—but Anney forgives Glen and takes Bone back home. The cycle continues until Bone’s uncles see her bruises and welts. They beat Glen severely and Anney finally moves the girls (Reese and Bone) to an apartment. Anney is so miserable that Bone eventually tells her to take Reese and go back to Glen but that she (Bone) won’t go with them.

Before Anney returns home, Glen comes to see her at Alma’s. Bone is home alone when he arrives. Bone tells him that she told Anney to go back home to him but that she (Bone) isn’t going with her. Glen goes crazy, and in a rage he beats Bone and then brutally rapes her. Anney comes in afterward and drags Bone to the car with Glen trailing behind crying and begging Anney to kill him. As Bone loses consciousness, she is disgusted to see that Anney is focusing her attention on Glen and not on her.

Bone awakens in the hospital. Raylene tries to help Bone recover both physically and mentally, but the fact that Anney never came to see her at the hospital eats at Bone constantly. Bone is raging inside, but she appears silent and calm on the outside. When Anney finally shows up at Raylene’s house, she tries to apologize to Bone for all that has happened. She explains she never thought Glen would hurt her, but that she loves him and just can’t see the bad in him. Bone realizes she has lost her mother… she is a stranger. Anney lets Bone cry until she has no more tears, then she tells her how much she loves her, and drives away. She leaves an envelope with Bone which she opens after Anney is gone. Inside is her birth certificate—without the hated word on the bottom.