Yura (also Yuri) Zhivago attends his mother's funeral. He is only ten years old and takes the loss hard. A short while later, his father jumps off a moving train, committing suicide. Orphaned and penniless due to his father's squandering of the family's wealth, Yuri is raised by others who send him to school.

Lara, a young schoolgirl, becomes involved in an affair with a much older man, Komarovsky. She tries to shoot him dead one night at a Christmas party. Yuri sees Lara occasionally but does not have any relationship with her at this point.

Yuri earns his degree in medicine and becomes Dr. Zhivago. Lara marries Pasha and starts a family in her hometown, Yuriatin. Yuri marries Tonia, a young woman with whom he had grown up. World War I begins, and Dr. Zhivago serves as a field doctor. Pasha leaves Lara to join the army. She trains to be a nurse and goes to find Pasha, who has been declared missing in action. On the front she meets Dr. Zhivago, who is wounded, and feels a mild attraction for him.

Yuri and his family move to Varykino in the Ural Mountains to escape the hard times in Moscow during the Russian revolution and civil war. They make as good a home as they can. Yuri discovers that Lara lives in a nearby town, Yuriatin. He goes to visit her, falls in love, and begins an affair. Two months later, full of guilt because he's cheated on his wife, Yuri decides to break off from Lara. On his way home, he changes his mind and rides his horse back to Lara. The Red Army stops him and conscripts him as a field doctor.

Yuri serves as a field doctor until he cannot stand war any longer. He deserts during a time that the Red Army fights a decisive battle with the White Army and wins the civil war. Yuri returns to Yuriatin and finds the key to Lara's place. There he falls ill. Lara takes care of him and they build a life together, but the government may want to arrest them. Yuri is under suspicion because he does not embrace the new government. Lara draws attention as the wife of Pasha, who had survived World War I to become an influential commander of the Red Army under the assumed name Strelnikov. Strelnikov himself is under suspicion for knowing too much.

Upon learning that the government will soon arrest them, Yuri and Lara hide out in Varykino. Komarovsky comes back into Lara's life, offering her safe travel to eastern Russia, where she will not have trouble with the government. Yuri does not accompany them due to concerns for his family, now deported to France. Strelnikov comes to Varykino and talks with Yuri. Having lost his country and his family, Strelnikov commits suicide with his own revolver. Yuri departs for Moscow.

Along the way, Yuri encounters a young man that he had met before, and they travel together to Moscow. There they work and share lodgings, but the young man becomes disgusted with Yuri. Yuri takes a common-law wife, which Tonia learns about. Yuri disappears. He later dies of a weak heart on the streets of Moscow.

Lara attends Yuri's funeral. She helps to gather Yuri's poetry together, which becomes published. Her fate is unknown, but the assumption is that she dies in a concentration camp.