Set in a small town in Ireland in the early 1960s, The Butcher Boy is the story of Frances “Francie” Brady, also known as “pig boy,” the only child of an alcoholic father and a mother driven mad by despair. As his troubled home life collapses, Francie retreats into a violent fantasy world. Held up for scorn and ridicule by the sanctimonious neighbor Mrs. Nugent, and dropped by his best friend Joe in favor of Mrs. Nugent’s son, Francie finally finds a target for his rage, and a focus for his twisted, horrific plan. Dark, haunting, and often screamingly funny, The Butcher Boy chronicles the pig boy’s ominous loss of innocence and chilling descent into madness.

Written in a hybrid of first-person narrative and stream of consciousness, critics marveled at Patrick McCabe’s unique use of rhythm and language upon the novel’s publication in 1992. Critic Tim Guathier claimed McCabe’s style of writing forces the reader to “constantly reassess Francie Brady’s psychological stability,” making the novel all the more terrifying.