A year has passed since the capture of the Surgeon, serial killer Warren Hoyt, yet the memory of his brutal crimes continues to haunt Boston homicide detective Jane Rizzoli. Now she faces a new killer, a hunter who preys on well-to-do couples. For Rizzoli the death scenes have a horrifying air of familiarity, especially when she realizes that this new killer is copying one obscure element from Warren Hoyt's crimes.

A new complication arises as a federal investigator from Washington joins the case. Again and again, Rizzoli clashes with Special Agent Gabriel Dean, who shows up at every crime scene. He knows something about this killer, something so politically explosive that he cannot reveal it to her.