Twenty years after a mysterious death rocks Wallace University, another murder takes place.

When anti-Kappa Dean Cathy Munsch decrees that sorority pledging must be open to all students, and not just the school’s silver-spooned elite, all hell is about to break loose, as a devil-clad killer begins wreaking havoc across the campus.

As Halloween approaches, Chanel creates a devious plan after Zayday makes a shocking announcement. Meanwhile Grace and Pete pay a visit to a mysterious woman with ties to Kappa's past. Also, Hester grows closer to Chad, Denise continues her search for the red devil killer and Dean Munsch does everything in her power to keep Wallace University open.

With Halloween just days away, Dean Munsch makes an announcement affecting the campus and, specifically, Chanel's plan to throw a pumpkin patch party in support of her Kappa Kappa Tau presidential campaign. Meanwhile, Grace and Pete lead a search party for a missing friend, which steers them closer to the Red Devil than ever before, and Chanel #3 and #5 learn what life would be like without Chanel.

Chad takes Chanel to his family home for Thanksgiving, where she meets his brothers, Brad and Thad, as well as his parents. However, an uninvited guest throws the holiday into chaos. Meanwhile, Dean Munsch gathers the survivors at Kappa House, but dinner quickly explodes into accusations of who among them is really the killer. Then, the Red Devil carves up a deadly main course as another victim falls.

Shocking confessions are made as the Red Devil is finally unmasked and the killer revealed.

Shocking confessions are made as the Red Devil is finally unmasked and the killer revealed.

Years after the murderous events at Kappa House, Dean Munsch purchases an abandoned hospital under the guise of fixing the healthcare system in America. After recruiting surgeons, Dr. Brock Holt and Dr. Cassidy Cascade, as well as medical student Zayday Williams, the Dean shocks everyone when she enlists the services of the disgraced Chanels to join the ranks at the teaching hospital. Meanwhile, secrets from the hospital’s past begin to reveal themselves and a new killer surfaces.

A new patient with a hideous ailment visits the hospital in hope of a cure, but finds a love interest instead. Meanwhile, Chad returns to win Chanel back and, in the process, discovers a dark secret of Brock’s. Then, after another run-in with the killer, Munsch enlists the help of new Quantico special agent Denise Hemphill.

After the latest attack by The Green Meanie leaves everyone shocked and saddened, Dean Munsch and Denise, along with Hester, devise a plan to catch the killer by throwing a Halloween party in the hospital. Meanwhile, Chanel celebrates a different kind of Chanel-O-Ween and attempts to make contact with the killer’s latest victim from beyond the grave. Once the party begins, an outbreak surprises the hospital, leading Brock and Cassidy to jump into action, and another victim falls.

After an influx of patents at the C.U.R.E. institute, Dean Munsch and Chanel organize a blood drive to solve the hospital's severe shortage. Meanwhile, Nurse Hoffel sets a plan of revenge in motion, Hester finds a way to join the hospital's staff and a shocking revelation involving The Green Meanie occurs.

A man from Dean Munsch's past checks in to the C.U.R.E. institute with plans to win her back, causing a jealous Brock to further question his relationship with Chanel. Meanwhile, Zayday and Chamberlain devise a plan to discover the origins of The Green Meanie killer with shocking results.

The Green Meanie sets its final plan for revenge in motion as Hester makes a bold move to secure her future, and Brock performs a dangerous surgery to save Dean Munsch's life.