The novel is a first-person narrative, a monologue by a young Jewish man, Alexander Portnoy, who is speaking to his psychoanalyst. He shares his struggles with his identity as a Jewish man in America, his sexual fantasies and frustrations, his complex relationship with his overbearing mother, and his experiences of guilt and shame. The book uses humor and frank language to explore themes of identity, sexuality, and the Jewish experience in America.

This novel explores the story of Neil Klugman and Brenda Patimkin, two young Jewish people from different social classes, who embark on a summer romance in 1950s New Jersey. The novel delves into their relationship dynamics, contrasting their backgrounds and dealing with themes of social class, materialism, and the American Dream. The book also includes five short stories, each exploring different aspects of post-war American Jewish life.