A stark portrayal of life among a group of heroin addicts who hang out in Needle Park in New York City. Played against this setting is a low-key love story between Bobby, a young addict and small-time hustler, and Helen, a homeless girl who finds in her relationship with Bobby the stability she craves.

Joe Buck is a wide-eyed hustler from Texas hoping to score big with wealthy New York City women; he finds a companion in Enrico "Ratso" Rizzo, an ailing swindler with a bum leg and a quixotic fantasy of escaping to Florida.