Doctor Zhivago tells the story of Yury Zhivago, a man torn between his love for two women while caught in the tumultuous course of twentieth century Russian history. Yury's mother dies when he is still a young boy, and he is raised by his uncle Kolya. He enrolls at the university in Moscow, studying medicine. There he meets Tonya, and the two marry and have a son, Sasha.
Yury becomes a medical officer in the army and is stationed in a small town. He meets Lara, a woman whom he has seen twice before. The first time, he visited the house of a woman who tried to commit suicide, and he saw Lara, the woman's daughter, exchanging glances with an older man, Komarovsky. The second time, Lara tried to shoot Komarovsky at a party and instead wounded a prosecutor from the courts. Lara is married to Pasha, a young soldier who is missing, and she has come west to find him. She has a daughter, Katya, whom she has left in Yuryatin, her birthplace in the Urals.
Yury is captivated by Lara, but he returns to his wife and son in Moscow. Times are difficult, and the family must struggle to find food and firewood. They decide to move east to Varyniko, an estate once owned by Tonya's grandfather but now being worked as a collective. The journey is long and difficult, but when they arrive they find plenty of food and wood. Yury goes to the nearest city, Yuryatin, to use the library. There, he sees Lara once more. They begin an affair that lasts two months before Yury decides to break off contact and confess all to his wife. On his way, he is captured by the partisan army, which conscripts him as a medical officer.
Yury is forced to remain with the army through the end of the war between the Tsarist Whites and the Communist Reds. When he is released, he returns to Yuryatin to find Lara. The two spend several months together, and then they go to Varykino to hide. Lara's former husband, Pasha, became a leader in the Urals but is now wanted. Komarovsky returns and urges them to go east with him to avoid being killed. Yury's family has been exiled to Paris, and he is promised the opportunity to join them. Yury tricks Lara into taking her daughter and going with Komarovsky, while he remains at Varykino.
Yury returns to Moscow and finds work. He begins living with Marina, the daughter of a family friend. He and Marina have two children. Yury's old friends Misha and Nicky encourage him to resolve his divided loyalties toward Tonya and Marina. He finds a new job but on the way to his first day at work he dies of a heart attack. Lara comes to the funeral and asks Yury's half-brother, a lawyer, if there is any way to track the location of a child given away to strangers. She stays for several days and then disappears, likely dying in a concentration camp. Years later, Misha and Nicky are fighting in World War II and encounter a laundry-girl, Tanya, who tells them her life story. They determine that she is the daughter of Lara and Yury.