Rebecca and Jack get into an argument about starting a family. The family backstory behind the long line of love for the Pittsburgh Steelers is revealed. After accepting his part in the play, Kevin realizes his script is relevant to his own life. Randall and Beth encounter an unexpected turn of events.

Kate interviews for a new job that seems just about perfect, although it comes with a catch. Randall doubts his career choice and wonders if he followed the right path. Kevin and Olivia's relationship moves in a new direction. Rebecca and Jack are conflicted on what to do when Randall tests as a gifted child.

The dynamic of Randall and Kevin's rocky relationship is explained. Beth and William spend time together, which unexpectedly brings to light a secret William has been keeping. As Rebecca gets back to work for the first time in years, both she and Jack acknowledge that there is distance between them. Toby is caught straying from his diet regimen, throwing Kate into crisis.

As Jack, Rebecca and the three kids make their way to Rebecca's parents' house for their traditional Thanksgiving holiday, an unforeseen detour occurs. Kate makes two drastic life-changing decisions. Kevin brings Olivia to Randall's house for Thanksgiving. Randall's heart is broken when he learns about a lifelong secret his mother has kept from him.

Kate, Kevin and Randall head to their family's cabin to get away after their chaotic family Thanksgiving. A very angry Randall finds comfort and explanation from his father, Jack. Olivia speaks a harsh truth to Kate, which drives a wedge between Kate and Kevin. Rebecca and Jack struggle with what to do when 9-year-old Randall tells them that he's been looking for his birth parents.

The Pearson family finds themselves at the hospital on Christmas Eve after little Kate comes down with appendicitis. When they run into Dr. Katowski, who is alone at the hospital, they realize they need to be there for him as much as he was once there for them. Presently, Kevin celebrates Hanukkah with Olivia and her family, Kate continues to pursue her big surgery and someone from William's past reappears in his life.