John Constatine celebrates his fortieth birthday alongside his friends and loved ones, including Swamp Thing and Zatanna, and the love of his life, Kit. However, things never burn bright too long for John Constantine, and he soons finds himself at his lowest point ever. Drunk and homeless, John must pull himself together if he is going to survive against the King of the Vampires, who comes looking for his blood.

After battling demions, elementals, and serial killers, John Constantine is betrayed by his own body. Years of chain smoking have led to lung cancer, and the Ruler of Hell has special plans for the soul of John Constantine.