The two meet at a street corner and brutally murder each other. At the same time, Wilma has seen the damage to her house and left with a large knife of her own. The murder of her beloved dog leads Nettie to take a meat cleaver and head toward Wilma's house.

Meanwhile, the town drunk Hugh Priest buys a fox tail from Gaunt and pays for it by sneaking into Nettie's house and murdering her dog. He is sent to Wilma's house where he destroys her windows, TV, and microwave with large rocks. Later, Brian is told that he must perform one more prank to finish paying for the card. Wilma warns Nettie over the phone that she will get revenge. Wilma presumes the note to belong to Nettie Cobb due to their rivalry. At the scene, he leaves a note warning Wilma that it is her last warning. Brian sneaks to Wilma's house while she is away and ruins her laundry sheets by flinging heaps of mud at them. The first to enter the shop, Brian Rusk, buys a Sandy Koufax '56 TOPPS card for 85 cents and a prank to be played on Wilma Jerzyck, a bitter woman with a severe dislike of a woman named Nettie Cobb. Little by little, the pranks worsen existing grudges between the townspeople until they start turning against each other or themselves, nearly bringing about the violent destruction of the entire town. The person doing a prank usually knows the target, but has no real quarrel or relationship with him/her. One person after another buys the treasures he has in stock, paying surprisingly low prices and performing small 'favors' (pranks) at his request.

They are all greeted by the seemingly-kind, old man claiming to be from Akron, Ohio (a possible reference to Acheron), Leland Gaunt, and they all ignore the sign hanging in his shop, ' Caveat emptor' ('Let the buyer beware'). Castle Rock's citizens then begin to come into Needful Things, each of them drawn by an item they want more than anything else. The story starts out in first person with the narrator greeting the reader and moves to third-person, introducing each of the book's diverse cast of characters and their complicated histories.

The story is set in the small, fictional town of Castle Rock, Maine, where a new shop named ' Needful Things' opens, to the curiosity of the townspeople.

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