Liz awakens in an unfamiliar bed in an unfamiliar room. Why is she on a ship in the middle of the ocean? Where is the ship heading? And who is this other girl named Thandi who is sharing her room? Liz finally comes to understand that she has been killed by a hitandrun driver and is bound for a place called Elsewhere.

Liz arrives in Elsewhere and is greeted by her grandmother Betty, a woman who died even before Liz was born. On the drive to her home, Betty explains how Elsewhere operates. Liz will live in Elsewhere and age in reverse. She is expected to decide on some sort of avocation (a job she loves) and to go on with her life until she becomes a baby. At that point, Liz will be "released" to return to Earth and given an entirely new life.

Liz resists the customs of Elsewhere. She is angered that instead of growing older and obtaining her driver's license and falling in love, she will get younger. She refuses to do more than sit each day at the Observation Deck and watch her family and friends back on Earth through the binoculars. Eventually, bored with doing nothing but viewing the events on Earth, Liz begins to accept her new life. She elects to help domestic pets become acclimated to life in Elsewhere and ends up adopting a dog named Sadie on the first day of her job. Later, Liz meets Owen Wells and falls in love.

Life, though, is no easier in Elsewhere than it was on Earth, and Liz has to learn how to deal with loss and change. In Owen's previous life on Earth, he was married. When his wife arrives in Elsewhere, Liz is displaced. She decides to take advantage of a special clause, known as the Sneaker Clause, and return to Earth now rather than wait for her inevitable infancy. At the last minute, Liz changes her mind. Owen rescues Liz from the water so she can return to life on Elsewhere. Liz continues to grow younger until, as the novel ends, she is released into the River to be born anew on Earth. ELSEWHERE explores how we all must cope with life and whatever is to come after our lives end.