In 1994, SWAT officers storm into the Murder House, pushing past Constance Langdon.
Sometime earlier at Westfield High School, four students are in the library with a teacher when they hear screams and gunshots from outside. Another student, Kevin, runs in, barricades the main doors, and says that a student is shooting the others. The teacher tells the five students to hide and they all duck down behind tables. The shooter tries to enter through the main doors but gives up and goes to a side door. When the teacher tries to hold it shut, the shooter fires through the door, hitting him in the back. The shooter than comes in and guns down the students one at a time: first Stephanie, then Kevin, then Amir when he tries to call out. When Kyle gets up and confronts him, the shooter kills him with a shotgun. Finally only Chloe is left and the killer disposes of her as well.
Back at the murder house, the police enter Tate's room and aim at him. He puts a finger to his head and pulls the "trigger."
In the present, Violet looks up the massacre and confirms that the five students she saw on the beach were five of the students that Tate gunned down in 1994. She calls for her mother and goes to the kitchen, only to discover that Constance is there. She explains that Vivien went to the grocery store and that she knows that Violet knows the truth about Tate. However, Constance insists that the house drove Tate to go on a rampage while they were living there. She then takes Violet to her home to introduce her to Billie Dean Howard, a woman that Constance claims is a genuine psychic. Billie explains how she doesn't want her gift but that she has no choice, and explains that some of the dead can't accept the fact that they have died and refuse to pass on. Violet doesn't believe it and Billie says that a spirit named Mary is there, and that the spirit doesn't understand Violet. Violet remembers visiting a dying old woman named Mary, and walks out. Constance asks Billie if she can trust Violet and the medium admits that she isn't sure.
Violet is relaxing and listening to music as she examines her stomach, and sees the baby's hands try to reach out through her skin. She snaps awake, realizing that she's had a nightmare, and looks briefly at her finger and the now-missing wedding ring. She then hits the panic button to summon Luke from the security company, claiming that she heard nothing. He doesn't find anything and tells her that he's fine coming there to reassure her. They discuss Ben's infidelity and Luke tells Vivien that his wife had an affair with another woman. Ben comes in and they tell him what happened. As he goes, Luke tells them that Hayley somehow escaped from the car as he was taking her to the police station. After the security man leaves, Ben tells Vivien that he has to use the house office because they can't afford to rent. Vivien tells her husband that he can use the house as long as he leaves at night, and he can still be a father to their children, but she's disgusted by him and disappointed in him as a man.
Vivien goes to the bathroom and takes out a razor blade, and prepares to cut herself yet again. She imagines cutting her throat, and then hears Tate asking her if she's scared yet. When Vivien turns around, however, there's no one there.
Ben meets with his new patient, Derek, who explains that he's obsessed with urban legends, including the story of Piggy Man, a butcher at the 1893 World's Fair that put on a pig mask to slaughter pigs in the pen. One day he slipped and the pigs tore him apart and ate him. After that, Piggy Man's customers turned up murdered, their throats cut. According to the legend, if someone looks into a mirror and summons Piggy Man three times, the killer will appear. Ben insists that they can deal with Derek's problem and schedules another session. As Derek leaves, Violet storms into the room, insisting that the darkness has hold of her. He hugs her and tells her that he has her and she's safe.
The next day, Vivien is trying to track down the ultrasound technician, Angela, from the hospital. Constance comes to visit and offers Vivien a plate of sweetbreads, saying that it's good for the baby. Vivien offers her condolences concerning Adelaide's death and Constance says that she's chosen to focus on the living. She then asks Moira to sauté the sweetbreads and leaves, but not before saying that they can use another sweet children in the neighborhood. As Moira prepares the sweetbreads, she tells Vivien that a husband cheating on his pregnant wife is unforgivable, as bad as murder, and that Ben will cheat again. The housekeeper serves up the sweetbreads except for the pancreas, which she says is better uncooked. Once Moira leaves, Vivien eats the sweetbreads and washes the dish, while staring at the pancreas.
At their next session, Ben takes Derek to the house's bathroom and tells him to go into the room on his own and try to summon Piggy Man. Derek balks, hyperventilating, but Ben turns off the lights and closes the door. Derek speaks the invitation twice, but then hears something in the bathtub. He pulls back the curtain and sees Gladys' corpse. When he yells, Ben comes in and assures Derek that there's nothing in the bathtub.
Vivien goes to Dr. Hall's office for an ultrasound. Ben arrives late and apologizes, but the doctor says that it's good for the father to be there. Ben insists that he's the father and that he should be there, and takes Vivien's hand.
Violet meets Leah at the empty pool and apologizes for her earlier doubts, admitting that she's seen the Murder House guests as well. Leah says that the Devil is real and has declared war on women everywhere. When Leah says that she can't sleep without taking pills, Violet asks for a bottle of them.
Violet goes to the high school and looks at the commemorative plaque for the students who died in 1994. The teacher, in a wheelchair, approaches her and figures that she's a psycho there to see the murder site. Violet apologizes and explains that she knows Tate's mother, and asks the teacher why he thinks Tate went berserk. The teacher admits that he has no idea how, and says that sometimes shut happens. Violet insists that something must have made a good person turn bad, but the teacher says that maybe Tate wasn't a good person.
Later, Vivien tells Moira that they're going to have to let her go because they can't afford her services. Moira says that she'll work for free rather than abandon an expectant mother, and hopes that the next owners will hire her on. The housekeeper then tells Vivien brought over some fresh brains and that they're good for the baby when eaten raw. Vivien reluctantly starts to eat them and then consumes them with increasing fervor.
When Violet returns home, she sees someone who she thinks is Tate walking through the house. She follows the figure down into the basement and yells at Tate to leave, but hears the twin brothers behind her, playing and yelling. Violet yells at them to get out but the ghosts of Fiona, Dallas, and Gladys appear, approaching her. Dr. Montgomery staggers toward her, asking if Violet is his next patient. Panicking, Violet runs to her room and hears the music playing as loud as possible. She turns down her iPod and discovers that Tate has written the words "I love you" on her chalkboard. Crying, Violet collapses on the bed and contemplates the bottle of pills that Leah gave her. After a minute she takes then entire bottle and collapses on the bed. Tate comes in and finds her, and drags her to the bathroom and into the bathtub. As he runs water on both of them, Violet revives and he tells her that it's okay.
At Derek's next session, he tells Ben that he can't take the anxiety anymore. Ben tells his patient not to let his fears dictate his life, but remembers one night when he saw Vivien and Luke talking in the kitchen. Irritated, Ben finally tells Derek to go home and perform the ritual, and prove to himself that Piggy Man doesn't exist. When Derek balks, Ben tells him that it's the only way for Derek to be free of his fear.
Vivien finally contacts Angela the ultrasound tech, who agrees to meet her at a church. When Vivien arrives and notes that she quit her job at the hospital, Angela tells her that she feels safe in a church. She explains that the image she saw on the ultrasound screen had hooved feet and was the Great Beats of the Bible. Vivien figures that Angela is insane and walks away while the woman screams Bible verse at her, calling Vivien an abomination and a harlot.
Derek goes home and enters his bathroom. After turning off the lights, he faces the mirror and summons Piggy Man three times. A robber emerges from where he's hiding in the shower and shoots Derek dead. When his companion runs in, the first robber explains that Derek called him a pig so he shot him.
Constance meets with Billie, who says that Adelaide is there and mad at her mother. The medium offers to pass on what Adelaide has to say, and Constance takes her hand and addresses her daughter. She says that she was overwhelmed by her responsibilities as a single mother and never said the things that she felt in her heart. However, she admired Adelaide for overcoming her problems and that she was the most beautiful girl that she ever met. Billie relays Adelaide's message saying that she thanks her mother and that on the other side, she's a pretty girl at last. However, she is glad that Constance didn't get her to the lawn of the Murder House, because she didn't want to become a ghost and become trapped with Tate. Adelaide admits that she's afraid of Tate now that she knows the truth.
In 1994, Constance tries to get to her son but the SWAT officers hold her back. In Tate's bedroom, he puts his finger up to his head and mimes shooting himself. He then goes for the gun beneath his pillow and the SWAT officers gun him down. The commander kneels by Tate and asks why he did it, but Tate dies without saying another word.
In the present, Violet is looking through a book of birds that she checked out from the high school library, and discovers that it was checked out by Tate. He appears in her room and says that he likes birds because they can fly away when things get crazy. When Tate wonders if she'll tell her parents about the pills, Violet says that she won't and that they know she's been tired recently because of the stress. Tate wonders why she's been cold and distant to him recently, and says that he'll leave her alone if that's what she wants because he cares more about her feelings than his. When Tate says that he'll never let anyone hurt her, Violet invites him to lie next to her and they both say that they're tired.