An American man and "a girl" sit drinking beer in a bar by a train station in northern Spain making self-consciously ironic, brittle small talk. The woman comments that the hills look like white elephants (hence the story's title). Eventually, the two discuss an operation, which the man earnestly reassures her is "awfully simple . . . not really an operation at all . . . all perfectly natural" (726).

The woman is unconvinced, questioning "what will we do afterward," but says she will have the operation because "I don't care about me" (727). A few moments later, however, she avers that they "could" have everything and go anywhere, suddenly as earnest as he had been earlier. When the man agrees that they "can" do these things, however, the woman now says no, they can't, her change in verb tense suggesting that the possible lives they once could have pursued (and produced) are even now, before any firm decision has been spoken, irrevocably out of reach. When the man says that he will go along with whatever she wants, the woman asks him to "please please please please please please please stop talking" or she will scream. The train arrives during this impasse, and once the bags are loaded, the woman, smiling brightly, insists she feels fine.