NOTE: This spoiler was submitted by Jeremy

The film opens in Port-Au-Prince, where photographer Victor Fielding (Leslie Odom, Jr) is taking pictures while on vacation with his pregnant wife Sorenne (Tracey Graves). She meets with a voodoo priestess, who performs a ritual to give blessings to Sorenne’s child.

The city then experiences an earthquake. Sorenne tries to escape her building but is terribly wounded under falling debris before Victor finds her. Before she loses consciousness, she asks Victor to protect their child. At the hospital, Victor is told by the doctors that attempts to save Sorenne may possibly kill the baby. He is forced to choose who to save.

Thirteen years later, Victor lives in Georgia with his daughter Angela (Lidya Jewett), who keeps photographs of her mother. Victor has lost his faith in God as a result of losing Sorenne. On the way to school, Victor chastises Angela for wearing a scarf that belonged to her mother. She goes to school with her friend Katherine (Olivia O’Neill). During class, they make plans with another classmate, Deshannah (Lariah Alexandria), to go out into the woods after school, but it ends up just being Angela and Katherine. Meanwhile, Victor is at his job where he is taking photographs for a family. He begins to see weird images like the child crying, and the family’s pictures appearing distorted on his laptop.

Victor calls Katherine’s home after Angela had told him that she was going to study there, but Katherine’s mom Miranda (Jennifer Nettles) says the girls were going to Deshannah’s house. They contact Deshannah’s mother and find out that the girls were planning on going into the woods. Victor joins Miranda and Katherine’s father Tony (Norbert Leo Butz) as they venture into the woods, where they come across an area where they find the girls’ backpacks, and Victor finds Angela’s shoes in the water. The parents then contact authorities, who begin to search for the girls.

During the time searching for the girls, Victor is visited by concerned neighbors who try to offer help, but he rejects them. While visiting a shelter, another man makes a crass comment toward Victor regarding Angela’s whereabouts, causing him to flip a table and nearly start a fight. A young man and his father end up finding Angela and Katherine hiding in their barn cellar, and the girls are taken to the hospital. Their feet are red and blistered, and their skin appears scratched up. Their behavior also seems disoriented.

Victor brings Angela home, where she tells him that she and the other girls played a game in the woods where they tried to contact Sorenne’s spirit, leading to them falling into the hole and getting lost. Angela starts to exhibit strange behavior, such as talking to an unseen entity and messing with the lights. When Victor tries to draw a bath for her, the water turns black, and Angela appears to have ripped off a toenail. Victor goes looking for her, and Angela then tries to wrap Sorenne’s scarf around his face. Victor then takes Angela back to the hospital.

Miranda and Tony bring Katherine and her younger siblings to their Baptist church. While the pastor gives thanks to God for Katherine’s return, she looks haggard and worn out. She walks out and then returns while the congregation does their communion while covered in blood, and she begins to repeatedly yell out “THE BODY AND THE BLOOD” until her parents come to subdue her. Miranda and Tony end up keeping her bedridden at home.

In Angela’s room, her nurse Ann (Ann Dowd) checks in on her, and Angela begins speaking to her about her past, along with the name of a child before Angela begins bleeding profusely from below. Ann goes to Victor’s home and tells her that she used to be practicing to become a nun until she got pregnant out of wedlock and had the baby aborted, something that she never told anyone else, but she heard it from Angela. Ann gives Victor a book from Chris MacNeil (Ellen Burstyn), who documented her experience after her daughter Regan was possessed.

Victor reads Chris’s book and watches interviews with her before seeking her out personally. He finds her at her home where she lives alone after stating that Regan cut off contact with her after she wrote her book. Victor explains his situation to Chris, who has spent the last few decades of her life studying other religions’ methods of exorcism.

Victor brings Chris to the hospital to see Angela. Chris believes it is the same demon (Pazuzu) that possessed Regan, especially since the possessed Angela tells Chris that Regan is waiting for her in Hell. They then go to Katherine’s home, where Chris meets the girl and also hears the same tauntings about Regan. When she gets too close in attempting to expel the demon from Katherine’s body, the possessed Katherine grabs a cross and gouges out Chris’s eyes, blinding her. She is rushed to the hospital, with Victor apologizing for what happened to her, but Chris doesn’t appear to regret trying to help.

After Chris is hospitalized, Ann speaks to a friend, Father Maddox (EJ Bonilla), who then tries to get approval from the Catholic Church to perform an exorcism. Katherine’s parents turn to their own friend and pastor, Don Revans (Raphael Sbarge). Meanwhile, Victor visits Sorenne’s grave and finds a hoodoo practitioner, Dr. Beehibe (Okwui Okpokwasili), so he enlists her help as well. Joining them is also Stuart (Danny McCarthy), a Pentecostal preacher. Maddox is told that the Church did not approve the exorcism due to the possibility of someone getting killed.

Victor, Miranda, and Tony gather the group as they bring Angela and Katherine together in the same house, binding them to chairs that are nailed to the floor while drawing a ring around them. They begin to attempt a ritual to exorcise the girls themselves. During the ritual, the demon, Lamashtu, speaks through Angela, revealing that Victor had originally chosen to save Sorenne instead of Angela, and Angela’s real voice comes out to yell at her dad for that decision. Lamashtu then states that one girl will live, and the other will die, with the parents being forced to choose who survives and who doesn’t. Maddox then returns after basically saying “screw it” to the Church, and he starts to perform his own exorcism. The demon then makes the girls’ heads spin, and it somehow causes Maddox’s own head to twist 180 degrees before he collapses dead.

Victor then begins trying to reach out to Angela, apologizing for his choice and even using Sorenne’s scarf to get the real Angela to come out. Tony then blurts out that he chooses Katherine to be saved, and Angela’s body floats upward as she regurgitates an acidic bile into the ceiling before collapsing, her heart rate flatlining. As Victor holds his daughter and weeps, Katherine appears alive for a second before her head goes limp. Her spirit appears in the same place where the girls ended up in the woods, and Lamashtu drags Katherine’s spirit to Hell because the chosen one is the one chosen to die. Angela wakes up while Miranda and Tony are left weeping over Katherine’s body.

Sometime later, Angela returns to her normal life and has a better relationship with Victor. Miranda and Tony are left mourning Katherine. As Victor visits Sorenne’s grave once more, Ann gives a statement to the police where she reaffirms her faith. Finally, Chris hears someone visiting her at the hospital. It’s Regan (Linda Blair), coming to reunite with her mother.

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Two young girls, Angela and Katherine, go missing in the woods after playing a game trying to contact the spirit of Angela's mother Sorenne, who died giving birth to her. When the girls are found, they begin to exhibit strange and terrifying behavior, leading their parents to realize that the girls are possessed. Angela's father Victor contacts Chris MacNeil, who wrote a book about her experience when her daughter Regan was possessed.

Although Chris attempts to help, the possessed Katherine gouges out her eyes with a cross, leaving her blinded. Victor joins Katherine's parents Miranda and Tony in seeking help from preachers of multiple cultures to try and exorcise the demon from the girls' bodies. The demon, Lamashtu, tells the parents that one girl will live while the other will die, and they must choose who survives and who doesn't. After Father Maddox is gruesomely killed trying to perform the ritual, Victor tries to reach out to the real Angela, having to apologize when Lamashtu reveals that Victor originally chose to save his wife instead of Angela when doctors gave him the choice. Tony chooses Katherine's survival, but the demon had tricked them into choosing who dies. Katherine's soul is dragged to Hell while Angela survives.

Victor and Angela return to a normal life, with Victor's faith in God somewhat returned, while Miranda and Tony must mourn Katherine. Chris is also later visited by Regan after a long estrangement.