The downside of coming off junk was I knew I would need to mix with my  

             friends again in a state of full consciousness. It was awful. They reminded  

                         me so much of myself, I could hardly bear to look at them.

Set in Edinburgh, the film begins with a narration from Mark Renton as he and friend 'Spud' run down the road after shoplifting to raise cash, with security guards in pursuit. Renton states that unlike people who "choose life", he and his mates have opted out of ambitious pursuits, preferring to live in a blissful, meaningless heroin-induced stupor. We are introduced to his friends: film buff Sick Boy, hanger-on Spud, keen footballer Tommy and unpredictable thug Francis Begbie. Sick Boy, obsessed with Sean Connery, is also a heroin addict, as Spud. In contrast, Tommy and Begbie openly criticise heroin use. Tommy lives an athletic, drug-free lifestyle. Begbie does not believe in heroin, but he is (ironically) a vicious drunk, eager to pick fights for the mere thrill of instigating physical altercations. This point is clearly illustrated when Begbie is seen casually throwing his pint glass off a bar balcony, injuring a woman and causing a large-scale pub brawl.

Sick Boy and Renton decide to quit heroin, but struggle with temptation. They join Tommy, Begbie and Spud in a club where all five men are in pursuit of sex. The other three men have more complicated nights. After complaining about his relationship problems to his mates, Tommy takes Lizzie home...although events unfol and the relationship ends. Spud drinks too much, as he's in a temporary abstinent relationship with his girlfriend, Gail. That night when Gail tries to have sex, Spud passes out and defecates on her bed. Renton flirts with a young girl named Dianne, who quickly dissects his bad chat-up lines, but takes him home anyway....and it is not until the morning that he iscovers her true age. . He tries to end their relationship, but she blackmails him into staying in contact lest she call the police and inform them of their one-night stand.

With their quest to be sober not as thrilling as hoped, Sick Boy, Spud and Renton decide to get back on heroin. Tommy is dumped by Lizzie and looks for solace in heroin like his mates, having been told it's "the ultimate hit... Better than sex." Renton's life of stealing and drugs continues, but quickly takes many turns for the worse - beginning with the screaming of Allison at their flat. The group discovers Allison's baby daughter, Dawn, has died. The cause of death, implicitly, is neglect while they were all present: an infant's distorted wails play over the preceding drug montage. All are shocked and feel terrible - Sick Boy, the father, most of all. A short time later, Renton and Spud are caught stealing from a department store (in a reprise of the opening scene of the film). Spud goes to jail but Renton avoids incarceration by voluntarily enlisting in a drug treatment programme where he is supplied with the heroin substitute methadone.

Even though his journey to sobriety begins with much love from his parents and mates (such as Sick Boy and Begbie), within hours Renton is back at the flat of his dealer and orders more heroin. Renton overdoses on the heroin and is dragged to the hospital, where nurses save his life. Seeing no other option, Renton's parents lock him in his own room to beat the addiction cold turkey. He has several hallucinations, including Spud in jail, a now drug addicted Tommy, and Dawn, Allison's dead baby, crawling toward him on the ceiling, framed by a bizarre TV gameshow in which host Dale Winton asks, "Is he guilty... or not guilty?"

Finally clean of heroin, Renton feels no purpose in life and decides to move to London and start a job as a property letting agent. Renton continues his sobriety while enjoying the vibrancy of London and saving up money on the side. His happiness is again short-lived, however, as Begbie arrives at his London flat seeking a hiding place from the police for armed robbery. Sick Boy suddenly shows up and decides to live with them as well - and once again, Renton is frustrated that he cannot turn these "mates" away. As things are boiling over in the small space, the three are told of Tommy's death back in Scotland. They return home and meet Spud, who is now out of jail and also sober.

Following Tommy's funeral, Sick Boy suggests a large and dangerous opportunity for them; the chance to buy two kilos of heroin for £4000 and sell it for up to £20,000. Begbie demands that Renton put up much of the money, having seen Renton's bank statements. Though he has bad feelings about the deal, Renton agrees. The foursome meet a big-time heroin dealer and end up selling the heroin for £16,000 - leading to a rare afternoon of celebration between all four mates. Merely hours after the deal is finished, Begbie draws a knife on an unarmed man in a pub and beats him severely while accidentally slicing Spud's hand open as well. Renton decides, as Begbie stands over the beaten man and demands a cigarette to come down from his "high", that he is going to steal the money from his mates, whom he slowly realizes are not really his mates at all....

That night, Renton pulls the bag of money away from a sleeping Begbie before he leaves. Taking the money and his passport, he leaves and vows to starts a new life: the life he described at the beginning of the film. While trying to leave with the money, Spud catches Renton in the act, but does not wake the others. When Begbie awakes, he is furious and begins to destroy the room, attracting the attention of the police and finally being arrested. Sick Boy goes home empty-handed. Spud, however, finds £2000 in a locker intentionally left for him by Renton so that he too can make a fresh start.

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