Zoe finds herself in the middle of Wade and Vivian's relationship, putting her in an awkward position. Things between Lavon and AnnaBeth are getting worse and starting to affect the town. Lemon is upset when she receives a less-than-perfect health inspection grade and devises a plan to get it changed. Meanwhile, George needs a distraction and begrudgingly agrees to go on a date with a Bible School teacher.
Fast-talking New Yorker and brand new doctor Zoe Hart has it all figured out - after graduating top of her class from medical school, she'll follow in her father's footsteps and become a cardio-thoracic surgeon. But when her dreams fall apart, Zoe decides to accept an offer from a stranger, Dr. Harley Wilkes, to work with him at his small practice in Bluebell, Alabama. Zoe arrives in this small Gulf Coast town only to find that Harley has passed away and left his half of the medical practice to her in his will.
She quickly finds that Southern hospitality isn't always so hospitable - the other doctor in town, Brick Breeland, is less than pleased to be sharing the practice with this young outsider, and his daughter, Lemon, is a Southern belle whose sweet disposition turns sour when she meets Zoe. Zoe's only allies are the mayor, former football star Lavon Hayes, her bad-boy neighbor Wade Kinsella, and handsome lawyer George Tucker - who just happens to be Lemon's fiance. Zoe is out of her element and ready to pack her bags, but a surprise visit by her snobby New York mother leads to Zoe's decision to stay in Bluebell for a while, discovering small-town life and a side of herself she hadn't known was there.