James Crissman explores cultural traits related to death and dying in Appalachian sections of Tennessee, Virginia, Kentucky, North Carolina, and West Virginia, showing how they have changed since the 1600s. Relying on archival materials, almost forty photographs, and interviews with more than 400 mountain dwellers, Crissman focuses on the importance of family and "neighborliness" in mountain society.

Written for both scholarly and general audiences, the book contains sections on the death watch, body preparation, selection or construction of a coffin or casket, digging the grave by hand, the wake, the funeral, and other topics. Crissman then demonstrates how technology and the encroachment of American society have turned these vital traditions into the disappearing practices of the past.