The novel is a post-apocalyptic horror story that centers around a solitary man who may be the last human alive on earth after a pandemic has turned the rest of humanity into vampire-like creatures. He spends his days fortifying his home, hunting for food, and killing these creatures while they sleep. At night, he is tormented by their attempts to break into his home and kill him. His isolation drives him to the brink of insanity, and the novel explores themes of loneliness, survival, and the human capacity for hope in the face of utter despair.

The novel explores the eerie and supernatural as it follows the life of a recovering alcoholic and writer in San Francisco who becomes entangled in a web of occult horror. After discovering a mysterious book, he is drawn into the world of "paramentals"—sinister entities that feed on the energy of the modern city—and must confront the legacy of a long-dead sorcerer. As the protagonist delves deeper into the arcane, he must unravel the secrets of an ancient mystical theory called Megapolisomancy and face the terrifying forces that lurk in the shadows of urban decay, all while grappling with his personal demons.

In this gothic horror novel, the third installment of a popular vampire series, the narrative intertwines ancient history with the modern world, as the vampire Lestat awakens Akasha, the first and most powerful vampire, known as the Queen of the Damned. Her radical vision for a new world order threatens both human and vampire existence. As she enacts her plans, a group of vampires with varied motives converges to confront her, leading to a climactic battle that delves into themes of power, immortality, morality, and the essence of what it means to be human. The novel explores the deep lore of vampire mythology, expanding upon the origins and rules of the undead, while also examining the personal struggles and relationships between these eternal beings.