The fates of many different people are linked to The Cold One: Jerry Washington, once a member of a street gang, now determined to save the woman he loves from a horrible fate; beautiful Susan Darly, who undergoes a terrifying transformation at The Cold One's hands; Dr. Lawrence Morray, who made a terrible mistake for which he cannot forgive himself; Julie Moore, whose fascination with Near Death Experiences brings her close to death herself; Govinda Sharma, who abandons home and family to journey halfway around the world because he knows he must; and journalist Peter James, more important to The Cold One than he can imagine, the man who will complete It—or destroy It.

In The Cold One, Christopher Pike creates a villain whose soft touch can wither a person's soul, whose great beauty conceals a black heart, and whose breath carries death in every exhalation. An emotionless being of great and ancient evil, the Cold One exists only to destroy mankind.