The body of murdered Elizabeth Mercer, nude and handcuffed, is found floating down the Hudson River in New York City. A grim pattern follows: two men are killed in the same fashion, each handcuffed before the fatal act. Paul 'Mac' McCormack, Perry King, an ambitious TV talk-show host, and Detective Larry Weeks, Norman Parker, a police detective and aspiring stand-up comedian, join forces to track down the killer. At the same time, Virna Nightbourne, Elizabeth Kemp, a student at the Art Students League, has been painting portraits that eerily mirror the crimes, while her roommate Muriel, Barbara Quinn, a nurse, notices the same unsettling link in the art.
Virna is haunted by a chilling vision: she draws a portrait of herself as one of the killer's victims and dreams of a woman bound to a bed. She explains to the police that her drawings come from unconscious memories, a capacity she has had since childhood for precognition and clairvoyance. She recalls a past incident in which she helped rescue a missing girl named Elizabeth from her hometown; the police later confirm that the woman found dead in the river was that same Elizabeth, now working as a bartender at a BDSM leather bar. The clues suggest a connected pattern, and the art she creates intensifies the sense that the crimes are not random but deeply tied to hidden memories.
Meanwhile, a third victim—a prostitute's client—is handcuffed in an elevator shaft and crushed by a moving elevator car. Late that night, Mac is attacked in his apartment by Willie Gonzalez, a Puerto Rican immigrant, Willie Gonzalez, Antone Pagán. He claims he was paid to attack Mac, but won't name his employer. He tries to flee on the fire escape and is shot dead by a police officer. The violence darkens the mood as the investigation expands beyond the initial crime scenes.
That same night, Virna accompanies Weeks to a stand-up show at the Comic Strip, where Muriel has agreed to stop by after work. During the show, Virna is summoned by a waitress to take a phone call—the caller, who identifies himself as the killer, informs Virna that Muriel is handcuffed to a truck outside the club, and is about to be crushed to death. When she attempts to save Muriel outside, Virna is attacked by the killer, who attempts to run her over with his car. During the altercation, Muriel arrives at the club by taxi, and finds a traumatized Virna.
Following the attack, Virna is brought onto Mac's television show to recount her brush with the killer. On air, Virna goes into a trancelike state and begins drawing a portrait of handcuffed hands; simultaneously, Muriel is attacked in her car by the killer, who handcuffs her to the steering wheel and binds her legs before weighting down the accelerator pedal. Unable to control the car with her bound hands, Muriel crashes through an industrial building and into the river, where she drowns.
For her safety, Virna goes to stay with Mac, while Larry attempts to unravel Virna's drawings in an attempt to uncover the killer's identity. In one of the drawings, Larry notices an ornate crab-like figure, which resembles a glass figurine Paul has in his house. Virna has a vivid vision of Elizabeth's murder, revealing the truth: She was asphyxiated during a sadomasochistic group sex session in which Mac, Perry King, along with three other men, bound, gagged, and raped her; the three other men are the same three male murder victims. A terrified Virna manages to flee Mac's apartment but is pursued by him to the rooftop, where he strangles her unconscious. Larry arrives and the two men get into a violent fight, culminating in Mac falling over the edge of the building, gripping onto Larry's hands. Larry pauses momentarily before letting Mac fall to his death.
Virna regains consciousness, and police descend on the building. Outside, as a flurry of reporters and authorities surround the scene, Larry and Virna depart together.
