The narrative centers on the illicit and destructive affair between Harry Wilbourne and Charlotte Rittenmeyer, which forces them to abandon their social standing and flee into a life of isolation. The protagonists seek an absolute, uncompromised existence, yet they are systematically dismantled by the physical realities of poverty, the consequences of an illegal abortion, and their own psychological volatility. The novel employs a non-linear, dual-narrative structure that alternates between two distinct stories—'Wild Palms' and 'Old Man'—to contrast the romantic obsession of the lovers with the stark, survival-oriented struggle of a convict caught in a flood.

Discussion often centers on the structural innovation of the book, specifically how the two disparate narratives reflect upon one another to create a unified thematic statement. Readers frequently highlight the stark contrast between the claustrophobic, self-destructive intensity of the lovers and the primal, external struggle of the convict against the Mississippi River. Critics often analyze the prose for its density and the way it challenges the reader to synthesize the disparate experiences of the characters. The work is widely recognized for its uncompromising look at the cost of absolute freedom and the inevitable intrusion of reality into human desire.