Neihardt frames Black Elk Speaks with his Preface and Author’s Postscript, which, though modest, remind readers of an editing presence. In these two pieces, Neihardt describes the circumstances of his conversation with Black Elk. Chapters 1 and 2 are preliminary to the description of the great vision in Chapter 3; they convey Black Elk’s confidence in Neihardt and record the first few years of Black Elk’s childhood, including the first time he heard voices at age five. Chapter 3, the longest and most complicated chapter of the book, describes the vision that Black Elk was granted when he was nine years old. Highly iconographic and symbolic, Black Elk’s early vision depicts his journey to a cloud world in the sky where six grandfathers give him sacred objects and empower him to maintain his people’s sacred hoop. From this vision, Black Elk gains a sense of himself as different from others in his band in ways that are both privileged and unsettling.

Chapters 4 through 9 chart increasing tension between the Sioux and white Americans, as settlement and commercial enterprise expand westward into Indian territory. The dislocation and loss of culture that the Sioux suffered as a consequence of such events as the discovery of gold in Montana and the building of the Transcontinental Railroad erupts in the Battle of Little Bighorn, recorded in Chapter 9. Black Elk’s narrative continues to recount the increasing dislocation of the Sioux as the U.S. Government annexed more and more Indian territory and established Indian agencies and reservations. At the same time, Black Elk’s vision perplexes him because circumstances do not seem to allow him to fulfill it. In Chapter 11, U.S. soldiers kill the great warrior Crazy Horse, whose loss is a grave one for the Sioux. In Chapter 12, Black Elk finds himself with a small group of his people in virtual exile in Canada, trying to avoid the inevitable reservation life.

Chapters 13 through 18 record Black Elk’s increasing anxiety about assuming his role as healer and holy man. These chapters also depict the performance of public rituals (the horse dance and the heyoka ceremony) that allow Black Elk to assume his role publicly. He has another vision, the dog vision, in Chapter 15, and in Chapter 17 performs his first cure.

Chapters 19 and 20 record Black Elk’s experience in Chicago, New York, and Europe, performing in Buffalo Bill Cody’s Wild West Show. While in London, he participates in a command performance to celebrate Queen Victoria’s jubilee. He becomes close to a young woman in Paris and suddenly falls ill while visiting her. The girl’s family take care of him until he recovers. During his illness, he has another vision.

In Chapter 21, Black Elk comes home to an almost totally displaced community, living on reservations, with the bison herd all but extinct. The ghost dance religion revives the Sioux; Chapters 21 and 22 chart Black Elk’s participation in that hope for an apocalypse. Chapters 23 and 24 describe the death of Sitting Bull and the massacre at Wounded Knee. Chapter 25 describes the aftermath of the massacre and shows Black Elk’s profound disappointment at his failure to enact the power that his vision gave him.