This novel begins when the reader meets Hazel Lancaster, a sixteen year-old girl who was diagnosed with stage 4 Thyroid cancer when she was thirteen years old, and is now surviving because of an experimental drug called Phalanxifor.She recently has become depressed about her illness and because of this, is continuously forced by her parents to attend a support group that specializes in children who are surviving with cancer.Hazel’s friend Isaac who lost his eye to cancer also attends the support group. It is through Isaac, at support group one day that Hazel meets Augustus Waters, who suffered from osteosarcoma but is now in remission.After the support group ends, Hazel and Augustus begin to talk to one another and as a result end up at Augustus’ house to watch a movie. When there, they begin to discuss Hazel's interests. After discovering Hazel’s favourite novel, An Imperial Affliction written by Peter Van Houten, Augustus decides that he too is going to read it, and immediately becomes as obsessed with the novel as Hazel.Hazel and Augustus begin to spend a lot of time with one another.
As their relationship begins to grow, Hazel slowly feels as if she is pulling herself away from Augustus.Augustus surprises Hazel by using his wish; cancer patients get a free wish, similar to Make a Wish Foundation,) to take them both to Amsterdam to meet the author of their favourite novel An Imperial Affliction.Although Hazel is happy with this idea, she realizes that she does not want to develop a relationship with Augustus.She does not want to become close with Augustus so that when she eventually dies, he will not feel a lot of pain.Hazel relates herself with a grenade who is one day going to blow up and cause pain.
One night Hazel wakes up to a pain in her head, which is so strong that she is admitted to the hospital.She has pneumonia.While in recovery, Augustus visits Hazel every day and lets her know that rather than caring about the pain that she is going to cause him with her inevitable death, he would much rather care about her.It was from this that Hazel realizes that she loves Augustus and after she is released from the hospital they fly to Amsterdam.
When Hazel and Augustus meet Peter Van Houten, they are shocked.He is nothing how they imagined him to be and instead is just an alcoholic who gave up his writing career. Van Houten is incredibly rude and insensitive with Hazel and Augustus, so they decide to leave before things get worse.It was later that night that they both shared their first kiss with one another.
During the flight back home, Augustus reveals a secret that he has been keeping from Hazel. His cancer has returned and has spread to numerous parts of his body.Noticing Hazel’s devastation Augustus tells her that rather than fighting for himself he is going to fight for her.When they return home Augustus is put through many treatments and none of them are working. He is not expected to live for much longer.However, even through all the pain and suffering, Augustus and Hazel still manage to find romance in their relationship.
A few days later Augustus dies.Hazel is devastated.After attending the funeral, Hazel begins to come to terms with the death of Augustus.She starts to spend more time with Isaac and is one day told by him that Augustus left something for her at his departure.It was a eulogy for Hazel.The novel ends with Hazel responding to this letter from Augustus.