Pink is a rock star, one of the many reasons which have left him depressed. Pink imagines a crowd of fans entering one of his concerts, and we begin a flashback on his life, and it is revealed that his father was killed defending the Anzio bridgehead during World War II, in Pink's infancy ("In the Flesh?"). Pink's mother raises him alone ("The Thin Ice"), and with the death of his father, Pink starts to build a metaphorical wall around himself ("Another Brick in the Wall, Part 1").

Growing older, Pink is tormented at school by tyrannical, abusive teachers ("The Happiest Days of Our Lives"), and memories of these traumas become metaphorical "bricks in the wall" ("Another Brick in the Wall, Part 2"). As an adult now, Pink remembers his oppressive and overprotective mother ("Mother") and his upbringing during the Blitz ("Goodbye Blue Sky"). Pink soon marries, is about to complete his "wall" ("Empty Spaces"). While touring in America, he turns to a willing groupie ("Young Lust"). After learning of his wife's infidelity, he brings the groupie back to his hotel room, only to trash it in a violent fit of rage, terrifying the groupie out of the room ("One of My Turns"). Pink, depressed, thinks about his wife, and feels trapped in his room ("Don't Leave Me Now"), and dismisses every traumatic experience he has ever had as a "brick" in the metaphorical wall ("Another Brick in the Wall, Part 3"), Pink's wall is now finished, completing his total isolation from human contact ("Goodbye Cruel World").

Immediately after the wall's completion, Pink questions his decisions, ("Hey You"), and locks himself in his hotel room ("Is There Anybody Out There?"). Beginning to feel depressed, Pink turns to his possessions for comfort ("Nobody Home"), and yearns for the idea of reconnecting with his personal roots ("Vera"), Pink's mind flashes back to World War II, with the people demanding that the soldiers return home ("Bring the Boys Back Home"). Returning to the present, Pink's manager and roadies have busted into his hotel room, where they find him drugged and unresponsive. A paramedic injects him with drugs to enable him to perform ("Comfortably Numb").

This results in a hallucinatory on-stage performance ("The Show Must Go On") where he believes that he is a fascist dictator, and that his concert is a Neo-Nazi rally, at which he sets brownshirt-like men on fans he considers unworthy ("In the Flesh"). He proceeds to attack ethnic minorities ("Run Like Hell"), and then holds a rally in suburban London, symbolizing his descent into insanity ("Waiting for the Worms"). Pink's hallucination then ceases, and he begs for everything to stop ("Stop"). Showing human emotion, he is tormented with guilt and places himself on trial ("The Trial"), his inner judge ordering him to "tear down the wall", opening Pink to the outside world ("Outside the Wall"). The album turns full circle with its closing words "Isn't this where ...", the first words of the phrase that begins the album, "... we came in?", with a continuation of the melody of the last song hinting at the cyclical nature of Waters' theme.[31]