The story starts with a long description of the action set in a train station surrounded by hills, fields and trees in a valley in Spain. A man known simply as "American" and his girlfriend are sitting at a table outside the station waiting for a train to Madrid.
"The hills across the valley of the Ebro' were long and white. On this side there was no shade and no trees and the station was between two lines of rails in the sun. Close against the side of the station there was the warm shadow of the building and a curtain, made of strings of bamboo beads, hung across the open door into the bar, to keep out flies"
It was hot, so the man ordered two beers. The girl remarked that the nearby hills look like white elephants, to which the American replied that he has never seen white elephants thus not knowing what they look like.
""They look like white elephants," she said.
"I've never seen one," the man drank his beer."
They ordered more drinks and started arguing about the taste of the alcohol, her claiming that everything tastes like licorice. The American scolded her and said that she should let them try to enjoy themselves. The girl replied that she was just having fun, then retracted her earlier comment saying that the hills don't really look like white elephants anymore.
""They're lovely hills," she said. "They don't really look like white elephants. I just meant the coloring of their skin through the trees." "Should we have another drink?""
They ordered more drinks, and the American mentioned that he wants the girl to have surgery. He calls her "Jig", although he never specified what kind of surgery he wants her to have. He seemed upset and tried to downplay the seriousness of the surgery. He claimed it would be simple, for example, but then says the procedure isn't actually surgery at all.
""It's really an awfully simple operation, Jig," the man said. "It's not really an operation at all." The girl looked at the ground the table legs rested on.
"I know you wouldn't mind it, Jig. It's really not anything. It's just to let the air in." The girl did not say anything"
The girl didn’t say anything for a while, and then she asked what would happen after the operation. The man said that afterwards everything will be fine, just like before, and that it will solve all their problems. He said he knows a lot of people who have had surgery and found happiness afterwards. The girl dispassionately agreed with him.
""Then what will we do afterward?"
"We'll be fine afterward. Just like we were before."
"What makes you think so?"
"That's the only thing that bothers us. It's the only thing that's made us unhappy.""
The American then claimed that he won't force her to have the operation, but he thinks it's the best thing to do. She told him that she will go through with the surgery as long as he still loves her and they can live happily ever after.
The man then pointed out how much he cares for her, but she claimed that she doesn't care what happens to her.
""I don't care about me."
"Well, I care about you."
"Oh, yes. But I don't care about me. And I'll do it and then everything will be fine.""
He weakly said that she shouldn't go for surgery if she really feels that way. The girl then walks to the end of the station, looks at the scenery and wonders aloud if they could really be happy if she had it. They argue for a while until she gets tired and makes the American promise to stop talking.
The Spanish bartender brings two more beers and tells them the train is coming in five minutes. The girl smiles at the bartender, but has to ask the American what the bartender said because the girl doesn't speak Spanish. After they finished their drinks, the American carried their bags to the platform and then returned to the bar, noticing all the other people also waiting for the train. He asked the girl if she felt better. She says she feels fine and is fine.
""Do you feel better?" he asked.
"I feel fine," she said. "There's nothing wrong with me. I feel fine.""