The book revolves around a young couple, Rosemary and Guy Woodhouse, who move into an old New York City apartment building with a sinister reputation. Eager to start a family, Rosemary becomes pregnant under mysterious circumstances. As she becomes increasingly isolated and ill, she discovers that her husband and their eccentric neighbors have malevolent plans for her unborn child, which are tied to a diabolical pact with supernatural forces. Her paranoia and fear escalate as she uncovers the truth about a conspiracy that involves the birth of the Antichrist, leading to a chilling realization about the fate of her baby.

The 1033rd greatest book of all time