Joanna is a woman having a nickname Johnsy. She is suffering from pneumonia and is now close to death. Outside the window of her room, the leaves fall from a vine tree. Johnsy decides that when the last leaf drops, she will die, while her best friend Sue, who stays with her, tries to tell her to stop thinking in such a negative way.
In the same building, an artist named Behrman lives below Johnsy and Sue. Behrman has been claiming that he will paint a masterpiece painting one day, even though he has never started it. Sue visits Behrman, telling him that Johnsy, who is dying of pneumonia, has come to believe that she will die when the last leaf falls off of the vine tree outside her window, Behrman takes these words as a complete foolishness, but he decides to visit Johnsy and see the vine tree from her window.
In the night, a storm comes with strong wind and heavy rain. So Sue closes the curtains and tells Johnsy to go to sleep, even though there is still one leaf left on the vine. But Johnsy protests against having the curtains closed, but Sue insists because she does not want Johnsy to see the last leaf fall. In the morning, Johnsy wants to see the vine tree to be sure that all the leaves are gone, but to their surprise, there is still one leaf left.
The leaf does not fall at all. Johnsy believes that the leaf stayed there to show how wicked she was in her whole life and now death has turned its face from her.
When Johnsy is strong enough and becomes well, Sue reveals to her that their neighbor Behrman has died of pneumonia and that the one remaining leaf is, in fact, masterpiece painting. Drawn just for the sake of Johnsy’s life and for her encouragement to get well.