The episode begins as Stan's bicycle is towed away for parking tickets. Stan attempts to make his case to a Park County official, but he only suggests that Stan get a job in order to make enough money to pay the tickets. His job is a newspaper route, however, and he needs the bike to do his job. The official then suggests that Stan do community service by coaching the Park County Pee-Wee hockey team.
As coach, he quickly runs into a whole host of problems in dealing with the small children. One has cancer, which has already spread to his bone marrow; this causes the other kids to ask Stan several serious questions which he has trouble answering due to his own youth and inexperience. Stan's father Randy becomes shocked that he would take such a job, and thinks that he is trying to "make up" for what happened when Stan was four and on the Park County Pee-Wee hockey team himself, when he missed a shot on an empty net and ended the game in a scoreless tie. Stan cannot even remember the event itself, only that they "went to Shakey's afterwards."
Nelson, the boy with cancer, takes a turn for the worse, and asks Stan to win a game for him. However, neither team is very good and the Adams County team ties Park County 0-0. This makes Nelson become "not worse, but not any better. It's almost as if his cancer is...tied." Nelson shortly went to the hospital later on, making Stan choose another teammate - Ike, Kyle's younger brother from Canada - to replace Nelson on the team.
The team is then invited to play against the Denver County team at the Pepsi Center, with the same basic premise — the idea being that if Stan's team wins, Nelson will have enough hope to survive. Randy confronts Stan about playing at the Pepsi Center, the same place where Stan did not win his game years ago. Stan still can't remember it, and while Randy initially says he will not be there to watch Stan "destroy himself", he then decides (without any actual prompting from Stan) to go anyway.
When they get to the Pepsi Center to play in the intermission of an NHL professional ice hockey game between the Colorado Avalanche and Detroit Red Wings, the other team does not show up, and Stan worries that since they cannot play, it could result in Nelson's death. Attempting to console the children, the Avalanche let the Pee-wee team play the final period of their game against the Red Wings, because they went through a lot of "emotional changes". Detroit and Colorado had been tied at 2-2, but with Stan's team playing the final period, Detroit wins 32-2 (30-0 during the final period); additionally, the Red Wings assault the children (similar to many fights in hockey), injuring many severely. Nelson dies in the hospital, one of the kids - bloodied - tells a shocked Stan that he hates him, and Randy snaps in anger over the loss of the Pee-wee team. The episode concludes with a spot on Red Wings' coach Mike Babcock, triumphantly jumping in the air while holding the Cup to the song "We Are the Champions" (ending in the standard Freeze frame shot), as described by Matt Stone on the commentary, "we stuck a happy ending there for someone else".