As Dexter stalks his next victim, a drunk driver who is about to be acquitted for vehicular homicide that resulted in the death of a teenage boy, the Ice Truck Killer strikes again and later gets in touch with Dexter. Meanwhile, when a cop is found murdered, Dexter helps Doakes and Debra investigate a crime boss who they believe is responsible.

"The Ice Truck Killer" strikes again and new homicide officer Debra is assigned the case, but she gets reprimanded for violating the chain of command; flashbacks offer insight into Dexter's homicidal tendencies and take him back to his first time "taking out the garbage"; Doakes gets on the bad side of a drug kingpin.

The Ice Truck Killer leaves severed body parts from his victims at locations that are linked to memories from Dexter's troubled childhood, which begins to get into Dexter's head.