In rural Missouri, serial killer Garrick Turrell (A. J. Bowen) escapes from police custody and immediately resumes taking the lives of strangers whilst searching for his ex-girlfriend, Sarah. Meanwhile, having met at group therapy for recovering alcoholics, Sarah (Amy Seimetz) and Kevin (Joe Swanberg) begin to develop a tentative relationship. As the body count builds, Turrell makes his way to Sarah's new location just as she seems to be getting her life in order.