When Cartman gets $2 from the tooth fairy, the boys come up with a scheme that will get them the new Sega videogame system. When the plan doesn’t work, they decide to go to a rich neighborhood and steal the rich kid’s tooth fairy money, only to discover they are going against a mob that has the tooth trade market cornered.
The boys are challenged to a sled race against the girls. When Token says the reason that they’ll win will be due to Cartman’s fat ass, Cartman throws a rock at him and gets into trouble. The FBI begins an investigation into his “hate crime” and make an example out of him by sentencing Cartman to juvenile hall until he reaches the age of twenty-one.
A new student in Mr. Garrison’s class has a problem: he is handicapped and can only say his name. The faculty believes that Timmy has ADD, which means that he does not have to do any homework. Everyone in the class soon manages to get diagnosed with ADD so that they don’t have to do homework. A side effect from the Ritalin given to the students is the complacency that will let them sit through an entire Phil Collins concert.
The boys discover the contorting quintuplets from Romania and decide to start up a circus act of their own. The quintuplets and their grandmother defect and stay at the Marsh home. When the girls' father and the Romanian government demand the return of the girls, attorney general Janet Reno comes to their aid. Meanwhile, Kenny has been taking lessons and finds himself singing in Romania.
When Cartman decides he wants to associate with more mature people, he turns to the internet and (much to his surprise) finds many men who want to be his "friend." However, Cartman is forced to turn to an organization specializing in the loving of little boys, NAMBLA. Meanwhile, when Kenny finds out his mother is pregnant, he tries to give her an abortion.
Kyle needs a new kidney, and the closest match in South Park is Cartman, who is happy to give Kyle his kidney for 10 million dollars. Mr. Garrison attempts to write a romance novel, and the town goes crazy for holistic healing remedies offered by two “native” Americans.
Chef declares that the town’s flag is racist and needs to be changed, leading to a classroom debate. Stan and Kyle support the current flag, while Cartman and Wendy side for the creation of a new flag. When Cartman actually starts participating in their research for the debate, Wendy finds that she has feelings for him.
At the insistence of Cartman, the boys form the boy band "Fingerbang." Auditions are held for a fifth member, while Cartman convinces the manager of the South Park mall to let them perform. Everything seems to be going according to plan until Stan is forbidden to be in the band due to his father's own dark musical past.
The children of South Park have questions about what kinds of people go to heaven, including the handicapped and Jews. Saddam Hussein returns to hell and learns that Satan is now seeing a man named Chris.
Cartman has begun preaching (and later faith healing) while the other children make plans to build themselves a church. Meanwhile, Satan is in crisis with his relationship with Chris and Saddam, so much so that he turns to a surprising source for help.
The kids have moved into the 4th grade, but they aren’t delighted, especially with their new teacher Ms. Choksondik. They decide to try traveling back in time to the simple life of 3rd grade. They find two college students who set up Timmy’s wheelchair as a time machine, but when it is activated Timmy disappears in time.
Cartman gets a new Dawson's Creek Trapper Keeper that a man from the future (claiming to be Bill Cosby) wants to destroy. The man claims that if he doesn't destroy the Trapper Keeper, it will one day take over the world. Meanwhile, Ike has started Mr. Garrison's kindergarten class. He gets on the ballot to be elected class president, but when the election ends in a tie, Rosie O'Donnell is called upon to figure things out.
The 4th grade is doing their own version of Helen Keller’s story, but when they're told the kindergarteners are putting on a “Thanksgiving extravaganza,” they decide to turn their production into a musical. Timmy is set to star as Helen in the play, but when Timmy's disabled turkey is passed over for a part in the play, Timmy has second thoughts about participating.
In a retelling of "Great Expectations," Pip’s origin is covered as he takes a job at the Havesham Estate where he meets the girl of his dreams, but she spurns him. He goes to London to become a gentleman, and upon his return to Havesham he discovers that she plans on breaking his heart and taking revenge on all men.
Cartman is sent to fat camp and “he” returns an amazing 40 lbs. lighter. What is his secret? Meanwhile, Kenny has begun doing crazy things for money and eventually winds up with his own television show, which culminates in a pay-per-view event involving Ms. Crabtree’s uterus.
So that he can attend the “Raging Pussies” concert, Kyle calls the police and accuses his parents of "molestering" him. Soon all the children have called the police on their parents and they are the only ones left populating the town. When a couple breaks down while passing through town, they find themselves in a town divided, one side controlled by Stan and Kyle, the other controlled by Cartman.
Kyle and Ike await the arrival of Mr. Hankey. When he doesn’t show up, Kyle calls the other boys together and they go searching for him in the sewers. They find Mr. Hankey living with his alcoholic wife and their three little nuggets. Mr. Hankey thinks that no one is into Christmas anymore, so the boys decide to spread some Christmas cheer by creating their own animated special featuring Jesus, Santa Claus, and themselves.