The story is about a black mother, young and single, named Rannie Toomer. Her baby boy, Snooks, is dying of double pneumonia and whooping cough. The baby is all Rannie has in the world. For five days Snooks has been sick and Rannie has not bathed in that time due to taking care of her sick baby. Rannie knows her baby boy is gravely ill and is waiting for the white doctor to come and make him better.
Sarah is an older black woman who is knowledgeable of old home remedies as well as magic. Sarah tries to convince Rannie to use the home remedies that she knows on her baby. Rannie will not allow Sarah to perform her home remedies for several reasons. Rannie doesn't believe in the power of ethnic remedies.
"Strong Horse Tea" is told in third person. The point of view at the beginning of the story is that of the baby's mother, Rannie Toomer, a young black woman placing all of her trust in the benevolence of the white mailman and white doctor and her faith in white medicine. The point of view then shifts to the white mailman and the reader can see his prejudice and disgust over Rannie's ignorance. Thus, he does not understand the direness of the situation.
The perspective once again shifts back to Rannie, who is still waiting for the doctor. Rannie realizes the doctor is not coming and finally follows Sarah's instructions for a home remedy. While Rannie is out collecting horse urine, Sarah sees that the baby has died.
The short story highlightlights the conflict between generations within the same culture.