The town of Cranford is in a flurry at the arrival of a new handsome doctor. His controversial treatment of an unfortunate carpenter is risky not only for the patient, but also his reputation. Elsewhere a family suffers a loss but forges a friendship.

An unexpected visitor shakes miss Matty, but she keeps it to herself. The rumor that the railway will reach the town ruins the happy atmosphere. When Miss Deborah goes to talk to Captain Brown of this, he is of no help, indeed their friendship is severely strained.

The theft of a leg of mutton starts a chain of events that can only lead to trouble for one family in Cranford. With Christmas comes an invitation for Miss Matty, that she is encouraged to accept. Dr Harrison's friend Jack persuades him to declare his affections for Sophy, but then plays a cruel trick.

Jem and Martha formalise their relationship, and live as lodgers with Miss Matty, who has fallen on hard times. Will her friends come to her aid and will she accept help? Dr Harrison is advised to leave town due to his reputation being in tatters, but Sophy is ill and his modern medicine could help. Lady Ludlow is prepared to lose everything for her absent son, but Mr Carter tries to find another solution.