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Betsy Connell, a Canadian nurse, recounts the curious circumstances under which she "walked with a zombie": Hired to care for Jessica Holland, the wife of Paul Holland, the owner of a sugar plantation in the Caribbean, Betsy sails from Canada to Antigua, where she is met by Paul and escorted to the island of St. Sebastian. As they sail to their destination, Betsy's dreams of island beauty are shattered by Paul, who cautions her that the beauty surrounding them masks death and decay. At the St. Sebastian dock, Betsy is met by a carriage from Fort Holland, whose driver tells her the story of how the Hollands brought the slaves to the island and explains that the statue of "T-Misery" in the Hollands' courtyard comes from the masthead of a slaveship. At dinner that night, Betsy is joined by Wesley Rand, Paul's half-brother, who informs her that their mother, Mrs. Rand, runs the village dispensary. While getting ready for bed, Betsy hears a woman's sobs coming from across the courtyard and goes to investigate. Following the sobs to a tower stairwell, Betsy begins to ascend the stairs when she is cornered by the cataliptic figure of Jessica Holland. After Betsy screams for help, Paul comes to the tower and puts Jessica to bed. The next morning, Paul upbraids Betsy for her childish behavior and warns her not to heed the island superstitions. Betsy then meets Jessica's physician, Dr. Maxwell, who explains that his patient's zombie-like condition is caused by an incurable tropical fever. On Betsy's day off, Wesley accompanies her to the village, and while he drinks himself into a stupor, a calypso singer performs a song about Paul and Wesley's rivalry for Jessica's love. After Wesley passes out, Mrs. Rand comes to the table and arranges to have him taken back to Fort Holland. That night, the distant drums of a voodoo ritual underscore the harsh words exchanged by Paul and Wesley over dinner. Later, Betsy is drawn to the sound of Paul playing the piano. When he sees her approach, Paul apologizes for bringing her to the island and admits to driving his wife mad. After their discussion, Betsy realizes that she has fallen in love with Paul and determines to make him happy by curing Jessica. Betsy administers insulin shock to Jessica, and when the treatment fails, Paul comforts her, prompting Wesley to accuse him of falling in love with his wife's nurse. When Alma, Jessica's maid, suggests that the voodoo priest might be able to cure Jessica, Betsy questions Mrs. Rand about the power of voodoo, but the older woman advises her against it. Ignoring Mrs. Rand, Betsy decides to take her patient to the voodoo priest, and Alma draws her a map to the "Home Fort." That night, Betsy leads Jessica through billowing fields of cane, past animal sacrifices and to the crossroads guarded by the towering zombie-like figure of Carre Four, the voodoo god. Finally reaching the village, Betsy enters a shack to consult with the voodoo priest. Inside, she is astounded to discover that the priest is none other than Mrs. Rand. After explaining that she uses voodoo to convince the natives to accept standard medical practices, Mrs. Rand tells Betsy that Jessica can never be cured, and Betsy takes her charge back to the house. The natives, inflamed by the presence of Jessica, intensify their rituals, intent upon drawing her back to the Home Fort. As the native drums pound, Paul admits that he is fearful of demeaning and abusing Betsy as he did Jessica, and asks her to return to Canada. That night, Betsy is awakened by the looming shadow of Carre Four and she runs to Paul's room for help. Mrs. Rand then appears and orders Carre Four to leave the Holland complex. The next day, Maxwell comes with the bad news that the native unrest has sparked an inquest into Jessica's illness. Mrs. Rand responds that Jessica is not sick but a zombie, a member of the living dead. Mrs. Rand explains that when she discovered that Jessica was planning to run away with Wesley, she put a curse on her, turning her into a zombie. Maxwell refuses to accept her explanation, however, and insists that Jessica is a victim of tropical fever. That night, the drums beat ominously as Jessica shuffles from the house to the front gates. Wesley, obsessed with freeing Jessica from her zombie-like state, opens the gates, pulls an arrow from the statue of T-Misery and follows her. Compelled to mimic the hand of a voodoo worshipper stabbing a doll with a pin, Wesley thrusts the arrow into Jessica and carries her into the sea as Carre Four follows, staring blindly into the night. Later, the natives discover the bodies of Jessica and Wesley floating in the surf and carry them back to Fort Holland, where Paul comforts Betsy.