- For the eponymous drug, see Vertigo (drug). For the dealer known under the same name, see Werner Zytle.
Thea is in trouble with the police after she gets caught using a drug called Vertigo. Oliver thinks the only way to keep her out of jail is to find the dealer, a man who goes by the name of The Count. Oliver turns to McKenna Hall, an old friend and current Vice cop, for help. Meanwhile, Laurel steps in to defend Thea, and Felicity gives Oliver some disturbing news about Moira.
Outside the courthouse Thea is bombarded by a huge media throng. Thea has worked out a plea arrangement with the prosecutor but the judge denies the deal, saying he wants to make her the poster child for the city's Vertigo problem.
The Queens' attorney gets to work on an appeal, but tells the family to be prepared for her to do jail time.
Oliver flashes back to being behind bars on the island. He tells Yao Fei Gulong to let him go, reminding him that he returned for him. Yao says "I can't" and walks away.
Oliver drops by the police station and meets with a vice detective named McKenna Hall he knew from their younger days. She is aware of The Count's name and shows him a file. She gently asks him to let the police handle the situation. Quentin notices Oliver is snooping around and asks McKenna about it.
In order to make an example The Count injects pure Vertigo directly into the blood stream of the dealer from the opening scene. This apparently creates agonizing pain for hours or days and eventually causes the person's heart to give out. The Count hands him a gun with one bullet, giving him the option to take revenge or end the misery. The man shoots himself. The Count finds it "interesting" that the vigilante is coming for him.
Laurel tells Quentin she sees potential in Thea and doesn't think she needs prison. Quentin says he'll make a few calls.
Oliver meets with his Bratva connections to try and get connected with The Count. He says he's interested in the drug business. In exchange for the help they ask him to kill a man. Oliver obliges.
This leads to a flashback to the island. Yao brings Oliver to an organized fighting circle Edward is using for unit cohesion. Yao shoves him into the circle and it appears they are to fight.
Back in present-day Oliver puts the body of the man he seemingly had just killed into his trunk. He places his finger under the man's chin and he pops back to life. Oliver tells John that in order not to blow his Bratva connection his plan is to meet with The Count as himself, then follow him to his hideout.
Laurel and Oliver talk to Thea about her legal situation. Thea says the judge has agreed to 2 years of probation and 500 hours of community service, provided Laurel supervises her. Thea says she doesn't want to do it and Oliver is furious. After Laurel leaves Thea says essentially that she wants to go to jail to ruin Moira's life. Oliver tells her their father admitted he was a liar on the boat. Moira overhears this and is upset with Oliver.
Oliver and John meet with The Count. John says he wants to have something to offer his night club customers. The Count tells him that 56 people died to perfect his product. Quentin and McKenna pull up with several vehicles to bust the meeting. The Count gets away, on his way injecting Oliver in the chest with the pure form of Vertigo. Oliver and John manage to get away.
John mixes up some kind of medicine and gives it to Oliver.
During a flashback Oliver recalls his fight with Yao. Yao beats him severely, then does the fake death move on Oliver.
Oliver wakes up from his Vertigo state, with John telling him that The Count only got a half dose into him. Oliver's told that The Count got away but they have a sample of what he injected into him.
Quentin and McKenna pay Oliver a visit. McKenna says she saw him at the scene. Oliver tells them he was working on getting The Count. Quentin says if they spot him at another deal he'll be put in jail. Moira tells Thea she had been lying to her about Robert because she wanted to preserve her positive memory of him. They appear to make up.
Oliver is still suffering some effect from his overdose. He collapses on the stairs.
During another island flashback we see Yao dump Oliver into the river in full view of Edward.
In present-day John wants to take Oliver to the hospital. He declines. Oliver brings the Vertigo to Felicity Smoak for analysis, hoping she can tell him which part of the city it was made. She finds it was made near an abandoned juvenile detention center. Against John's wishes Oliver goes after The Count.
Unable to handle his bow because of the overdose the Hood has to fight his way through The Count's soldiers. As he makes his way up to the area where the drugs is being made the police arrive. The Hood fights with The Count and begins injecting him with his own product. At this moment Quentin arrives. the Hood shoves The Count away and leaves the scene.
Thea comes to her senses and decides to take the deal working for Laurel.
McKenna gives Oliver a call with word The Count has been arrested and put out of business. We see The Count battling for his life in a hospital.
Another island flashback. When Oliver hits the water he wakes up and is able to swim to shore. In his pocket he finds a map Yao has slipped in there.
In present-day Felicity asks Oliver to meet her. After asking if she can trust him, Felicity shows him a book identical to his father's. She says she got it from Walter, who told her it belongs to Moira. Felicity thinks the list cost Walter his life.
Preparation ran from November 5 until November 14, 2012. Shooting ran from November 15 until November 26, 2012.
- Oliver and Alexi talk about Anatoly Knyazev. Anatoly will later become a major character in the flashback storylines of season 2 and season 5 and a recurring character in season 6.
- Oliver told Alexi that he saved Anatoly's life. It's unknown if he's talking about him freeing Anatoly from the Amazo in season 2, or about him saving Anatoly from Gregor in season 5.
- The drug dealer Oliver interrogated at the beginning is played by Patrick Sabongui, who also plays Captain Singh on The Flash.
- Katie Cassidy, Eileen Pedde and Serge Houde previously appeared on Supernatural.
- In the last flashback of the episode, when Oliver comes out of the river and is looking at the map, he says to himself, “Survive”, but his lips don’t match the dialogue.
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