Them chronicles the tumultuous lives of a family living on the edge of ruin in the Detroit slums, from the 1930s to the 1967 race riots. Joyce Carol Oates traces the aspirations and struggles of Loretta Wendall, a dreamy young mother who is filled with regret by the age of sixteen, and the subsequent destinies of her children, Maureen and Jules, who must fight to survive in a world of violence and danger.

The novel has been praised for its commentary on the difficulties faced by the American working class and depiction of lower-class tragedy through its descriptions of urban life and the interweaving of colloquial language with prose. Geoffrey Wolff wrote, "This novel is a charnel house of Gothic paraphernalia: blood, fire, insanity, anarchy, lust, corruption, death by bullets, death by cancer, death by plane crash, death by stabbing, beatings, crime, riot and even unhappiness. Its ruling principles are hate and violence."