Gonçalo and Johanne wait patiently at Sophia's bedside for Paquete and Otis to return from the FEMA command post at the high school, so that Hershel Greene can perform the surgery that will save Sophia's life. Gonçalo, weak from multiple blood transfusions to keep Sophia alive. Focused on Sophia's health, Johanne begs him to eat to keep his strength up, while Gonçalo tries to convince her that Sophia will be fine.
Otis and Paquete, have gotten themselves into the high school's auditorium, but they can't outrun the walkers. When Paquete spots a window and suggests they try to jump through, Otis rebukes him on account of his size. He instead tells Paquete to go for the windows on his own, while he draws the walkers away to the locker rooms - where the windows are larger and he can escape.
Otis' plan works, and he's able to draw most of the walkers from the auditorium, growling and reaching for him as they go, while Paquete shoots at the dead from the atop the bleachers. Paquete makes it to the window, but a walker follows him, grabbing for him through the broken window frame. He grabs his gun and shoots the walker, but falls two stories below and lands hard on his ankle.
Kiko, Cassandra, and Fábio arrive at the farm and nervously discuss whether they're supposed to knock; they hadn't knocked on anyone's front door in months. But they're surprised by Maggie Greene, sitting in a darkened corner on the porch, listening in on their conversation. "Close the gate up the road when you drove in?" she asks, and Kiko sputters a yes. Maggie smiles and invites them inside, where they find Daniel with Diana and Inês, and Johanne and Gonçalo at Sophia's bedside with Hershel. Crsitina and Alexis come from the kitchen and Cassandra, Kiko and Fábio get stunned when they see them. Cassandra cries Cristina's name and runs to her. Kiko and Fábio embrace Alexis as well.
Paquete and Otis are taking too long to return and Sophia's condition is growing worse. Hershel informs Gonçalo and Johanne that he may have to attempt the surgery without the equipment, and that they’re going to have to make a choice sooner rather than later. They decide to fight for their friend as Paquete fights for his life at the school. Limping, Paquete is about to be overrun when Otis saves his life from approaching walkers, though they both use their last rifle and shotgun rounds. They start to limp away as the walkers tear at the fences.
Sophia wakes briefly, and talks excitedly about the deer that she saw, but he then has a seizure. His pressure bottoms out and Gonçalo desperately offers to do another transfusion. Hershel doesn't want to take any more blood from him in case he goes into a coma or suffers cardiac arrest, but he begins to take out his kit anyway - it's the only way to keep Sophia alive until Paquete and Otis get back. "You're wastin' time," Gonçalo says.
Unable to sleep, Leandra joins Caramelo on the roof of the RV to take watch. She can tell that Caramelo is worried about Cassandra, and tries to comfort him. But Caramelo leaves her alone on the roof.
At the farmhouse, Patricia is busily stitching up Fábio’s arm. As Sophia sleeps, Johanne and Gonçalo tell Hershel that they want him to start the operation without the equipment. Patricia pulls the shade off a table lamp as Hershel sterilizes his equipment. He's getting ready to start when the pick-up pulls into the driveway, the headlights shining in through the window.
Paquete has arrived with the supplies, but Otis isn't with him. He's stunned, quiet. He tells them they were swarmed, and Otis didn't make it. Hershel demands that no one tell Patricia until after the surgery, and Maggie sobs as Gonçalo embraces Paquete for bringing back the equipment, and comforts him saying that Otis wanted to make it right.
Kiko comforts Maggie over the loss of Otis, and she tells him about her stepmother and stepbrother, who both became Walkers. Hershel is able to stabilize Sophia, which leaves Gonçalo and Johanne near tears. Daniel offers to help Hershel with informing Patricia about Otis. As she sobs, Paquete looks on from the living room.
He goes to Sophia's room, where he finds Johanne at her bedside and stands back nervously. "Stay," she says to him. Maggie finds him in the hallway and hands him some overalls. "I brought you some clothes. They won't fit well; they were Otis'."
He goes to the bathroom and has a shower as he remembers what happened at the high school.
Otis pulls Paquete along after he collapses from his ankle injury. They manage to get to the parking lot, each of them down to their last round of ammunition. Paquete tells Otis to leave him and take the supplies, but Otis refuses to leave him there and pulls him up.
Paquete hobbles as the walkers get closer with every step. He looks at Otis. "I'm sorry," he says, and Otis looks on, confused, as Paquete shoots him in the leg with his last bullet.
He grabs for Otis' backpack with the supplies inside, but Otis fights him, grabbing at a chunk of his hair and punching him, but Paquete is able to overpower him and take the man's gun.
The Walkers descend on Otis, devouring him while Paquete is able to hobble away unnoticed.
Back inside the Greene bathroom, Paquete dries off while we see his bald spot.
- Last appearence of Otis.
- This episode marks the final credited appearance of Pruitt Taylor Vince (Otis), after being killed off in the episode. Archive footage of his death in the episode was used in, "Cherokee Rose".
- Paquete becomes the first character in the TV Series to be responsible for the death of a living character (Otis).
- The title of this episode, "Save the Last One," references the well known rule in zombie apocalypse stories that survivors should always save the last bullet for themselves if surrounded by a group of zombies. This makes the title quite misleading, as Shane doesn't use his last bullet on himself, but on Otis
- The cover of this episode features Gonçalo and Sophia.
- In this cover we see Sophia embracing Gonçalo, even though that doesn't happen in this episode, since Sophia has been shot.