Blow Fly presents Scarpetta with her most challenging case yet - and the biggest shock of her life. It also reveals a vastly different Scarpetta than the strong and powerful medical examiner we've seen before. The book continues with the dramatic narrative and character developments that began with Point of Origin, in which Scarpetta's beloved Benton Wesley was killed, and continued through Black Notice and The Last Precinct, in which she grappled with the malevolent Chandonne crime family and faced trials unlike any she'd known. Now, stripped of her title and her power, Scarpetta has left Richmond to return to her native Florida, where she works from her modest home as a private consultant - while desperately trying to overcome the paralyzing fears and emotional scars remaining from her recent battles.

While serving as a guest lecturer at the National Forensic Academy, Scarpetta meets Nic Robillard, a Louisiana police officer trying to prove herself on her small town's all- male force. Ten women have been abducted from Robillard's region and are now presumed dead, and neither Nic nor Scarpetta realizes that the brutal predator behind these disappearances knows Kay and is trying to attract her notice. At the same time, Scarpetta receives a disturbing note from a terrifying former adversary - Jean-Paul Chandonne, the vicious Wolfman who attempted to kill her in her own home. Chandonne promises he'll reveal details about his family's various criminal enterprises, but there's a catch. He wants Scarpetta to visit him in jail and serve as the doctor who delivers the lethal dose at his execution. It's only when Scarpetta travels to Baton Rouge to consult on a case involving an apparent overdose that she begins to see the ties between these various incidents - and uncovers a devastating personal connection to them that will drastically change her life.