麦克默菲由于厌恶监狱里的强制劳动，装作精神异常而被送进了精神病院。自从他来到后，本来平静的精神病院就发生了一连串的事件。
精神病院远非是麦克默菲想像中的自由的避难所。护士长拉契特制定了一整套秩序，一切都要以此为准则。病人们受到了严格的管制，还不时的受到她的侮辱和折磨。麦克默菲对拉契特的行...为十分不满，不时以冷嘲热讽的方式对她加以攻击。在精神病院里，病人们被剥夺了自由地追求自己生存欲望的力量。拉契特处处和麦克默菲为难。她用大音量的刺耳音乐折磨病人们，并冷酷地拒绝降低音量的要求。在酷爱棒球的麦克默菲提出看世界锦标赛的实况转播时，拉契特又想方设法推搪拒绝。虽然麦克默菲最后得到了高大的印第安人“酋长”的支持，凑够了表决的票数，但拉契特却又以表决时间已过为借口而拒绝打开电视机。
麦克默菲想让病人们打起精神，快乐的生活一天。他把病人们带上了汽车，来到了一个小港口。他们偷了一条船，到远海钓鱼作乐。病人们欣喜若狂，过了十分快乐的一天。回来后，麦克默菲受到了惩罚。但不久，他就又把自己的女友和另一个女人弄到了医院，闹得天翻地覆。闻迅赶来的拉契特侮辱了病人比利，使他割脉自杀，而冷酷的拉契特却无动于衷。这使原想要逃离病院的麦克默菲再也抑制不住怒火，他扑上去掐住了拉契特的脖子。拉契特没有死，可麦克默菲却受到了最惨无人道的待遇。病院切除了他的脑白质，使他成了一个完完全全的白痴。“酋长”悲痛地将他搂在怀里，用枕头闷死了这个实际上已经死亡的生命。之后，“酋长”砸开了铁窗，逃出了这个令人窒息的地方。
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