Edgar Freemantle is a successful contractor in St. Paul, Minnesota but one day at a job site his truck is crushed by a crane and, he loses his right arm, has severe head injuries, and serious mood changes. His rage destroys his marriage and he, based on a travel brochure, decides to a small island off the coast of Florida and stay for a year. To fill his time, he decides to try to revive an interest in painting that he once had.
When he arrives at the island he moves too Salmon Point and names his pink house, Big Pink. The closest neighbor is Elizabeth Eastlake, and elderly women, who has spent her entire life on the island and owns half of it. He becomes friends with her and her live-in helper, Jerome Wireman. He learns from Elizabeth about many of her family, who lived on the island before and had violent endings.
His paintings all include scenes from the island, but his psychic influences him, and he brings parts of his family into the pictures and eventually the paintings also reflect Elizabeth’s memories. When he paints he seems to feel his lost arm and when that feeling is strong the paintings come fast and reflect things that he did not know about his family, and the past on the island.
Elizabeth tells him of losing her two sisters when they were young, almost 90 years ago. She tells him that the island is no place for daughters, when she learns that one of Edgar’s daughters is coming to see him.
Edgar begins to understand that his paintings allow him to change events, places, and people. Miss Eastlake, even though normally not conversant because of her Alzheimer's, does have clear spells and encourages Edgar to paint, and then to use a local gallery to sell them. She cautions him to make sure they are sold and taken off the island where she fears that they might do harm.
The local gallery loves the paintings and arranges a show. Edgar’s family and past friends all come. Elizabeth gets well enough to attend the show, but she dies right after the show, and Edgar’s daughter is killed by a women who bought a picture at the show. It becomes clear that those who have his painting are in danger.
Edgar learns that as a child Elizabeth had the same experiences painting at Duma Key and she even painted many of the same paintings. The paintings point to an influence named Perse. That name had been on some of the paintings. Edgar finds paintings from Elizabeth’s youth and understands what has happened. She also had her reality changed with her paintings and she lost loved ones.
Edgar, along with Wireman and Jack go to the house Elizabeth lived in as a child. At this point Edgar knows what Perce’s weaknesses are and how to fight back against the forces of evil she unleashes. They find Perce and destroy her.
Edgar and Wireman both leave the island. Edgar continues to paint, and his final painting is of a storm destroying Duma Key.
