Letters from Rifka is the story of a young Russian-Jewish girl and her family who leave their homeland in 1919 to travel to America. Persecuted in Russia by the soldiers and others who dislike Jews, Rifka's family makes their way across Russia to Poland and the U.S.

However, Rifka encounters many difficulties along the way. Initially worried that they will not make it out of Russia, the family runs into guards on the train on the way out (whom Rifka successfully distracts), and unkind guards at the Polish border as well. In Warsaw, Rifka comes down with typhus and slowly the whole family, except her brother Saul, comes down with the disease and must be hospitalized. Thankfully, they all survive.

When the family arrives in Warsaw and goes to the steamship office, though, Rifka is not allowed to purchase a ticket: a doctor has diagnosed her with ringworm. Heartbroken, she must stay in Europe as her family goes forward to the United States. Left in the care of the Hebrew Immigrant Aid Society, she is sent to Antwerp, Belgium, for treatment.

In Antwerp, Rifka flourishes. She lives with a kind couple, gets treated by a nurse who teaches her Flemish, and makes friends in the park across the street. She has a talent for languages and reads quite a bit. All of her hair falls out during the treatments; though it does not grow back, the nun who is treating her says that she is cured and she gets sent to the U.S.

Though the ocean crossing is rough, Rifka successfully makes it to Ellis Island, though a sailor friend she makes along the way, Pieter, dies in a storm. Once she makes it to Ellis Island, she is detained because she is bald. The doctors must make sure that she no longer has ringworm and, more importantly, want to see her hair grow back so that she does not become an unmarried woman, a "ward of the state." In the detention center, Rifka starts to learn English and becomes quite good at it quickly; she adopts a small Russian boy and takes care of a baby who later dies of typhus.

Rifka's family comes to visit her and she attempts to convince the officials that she will do what she wants with her life, whether it involves being married or not, which she will do with or without hair. When they listen to her, they agree, but immediately thereafter discover that her hair has started to grow back anyways - she is free to go into America with her family.