This novel deals with the relationship between a devoted piano teacher, the Madame Sousatzka of the title, and an aspiring young pianist. The action takes place largely in the dilapidated London home of Sousatzka where three other colourful characters also live. One is a 'countess' in retirement who spends most of her time sitting and looking at the world, the second is a gay osteopath whose theories aim to benefit mankind, and the third, Jenny, is a woman-of-the-evening, albeit one of especial beauty and delicacy. Sousatzka herself came to Britain as a refugee from Russia. She has developed her own system for teaching the piano, but even she has doubts about its efficacy. Madame Sousatzka specialises in child prodigies. In her hands the new boy will blossom into musical genius. But the public cannot hear him yet: until his debut he belongs to Sousatzka and her bizarre hot- house tenants. One day he will be a great pianist - until that day he must play only for Sousatzka …