Casey faces pressure to cover for a cop's son, who was responsible for a drunken-driving accident that left a teenager paralyzed. Meanwhile, Severide ignores his doctor's warnings that his neck injury may never heal if he doesn't seek treatment; and Mills must choose between working at the fire department full-time or helping his mom with her restaurant.

Chief Boden is accused of leaving a homeless man to die in a warehouse fire after ordering his men to evacuate the scene, creating negative press and bad feeling within the department. Meanwhile, Lieutenant Severide helps an elderly woman facing some neighborhood problems. Detective Voight ramps up his intimidation tactics aimed at Casey in an attempt to discourage him from testifying against his son. Shay is forced to revisit her heartbreak over her ex-girlfriend Clarice, when she finds herself face-to-face with the ex and her husband during a call. Hermann’s temper flares during a rescue call at a Halloween block party.

Everyone in the firehouse is ordered to take a drug test after a call to a daycare center exposes them to a makeshift meth lab, and Severide stalls, not wanting his injury, or the painkillers he takes, to be discovered. Meanwhile, Truck and Squad find themselves pinned down by gunfire while trying to help the victim of a gang shooting, and a deep-fried turkey fire grows from small to explosive when a garage catches fire. Elsewhere, Dawson saves a bleeding man and Casey delivers a baby on the scene of a massive car pileup on the freeway.

At the site of a train accident, Peter Mills becomes deeply upset when he observes the dead body of a young victim. Unable to shake his emotional distress about the event, he questions his future as a firefighter. Dawson and Shay save a 6-year-old girl whose mother is abusing her – but their confrontation leads the woman to resort to dire actions. Meanwhile, Severide aggravates his injury while rescuing a heart attack victim and Shay sends Clarice, her married, pregnant ex-girlfriend, back home to her husband.

Herrmann tries to rescue a toddler from a structure fire. Mills discovers unexpected news.

Truck and squad are called to the scene of a car crash that has Mills desperately working to save the life of a driver seriously injured in the wreck. Meanwhile, Casey has some doubts about Jack Nesbitt, whose strip club he is remodeling on the side. Elsewhere, Hermann, Otis, Cruz and Chaplain Orlovsky help get their team ready for the peewee hockey championship, but Herrmann might prove more of an obstacle than the other team.