Gideon and his wife, Suzie, live in South Central Los Angeles, though they retain some of their rural southern ways, including raising chickens in the backyard. Harry, a longstanding friend from the South who they have not seen for many years, makes a surprise visit. The couple are delighted to see him and insist that he stay with them for as long as he wishes. Harry has a charming, down-home manner, but his enigmatic and somewhat amoral presence brings to a crisis trouble simmering in the family—especially as regards the younger son, Samuel or "Babe Brother", and his relationships with his parents, wife, and older brother, Junior. Harry's disruptive and even corrupting presence threatens to break up Samuel's marriage and seems to be related to the illness that puts Gideon in bed for a couple of weeks, but is ultimately purgative: Gideon's extended family is more cohesive as a result of Harry's visit. Samuel and Junior struggle over a knife in a climactic fight during a storm, which ends in Suzie sustaining a wound. During a long wait in the emergency room, the storm clears, and the simmering anger that Harry seemed to bring to a boil is also dissipated. Harry's death just before the end of the film suggests, ambiguously, that he has been to a degree a self-sacrificing savior of the family.
The film has received positive acclaim. As of May 2019, To Sleep with Anger holds a rating of 87% from 30 reviews with the consensus: "To Sleep with Anger examines cultural tensions with a deft hand and a potent blend of comedy and drama, stirred skillfully to life by a strong cast led by Danny Glover." Chuck Bowen of Slant Magazine called it a "neglected masterpiece of African-American cinema." IndieWire's Brandon Wilson has called it Burnett's "other masterpiece," as well as numerous other favorable comparisons to Killer of Sheep, saying "Like all great art, To Sleep With Anger triumphs because it works both on a personal level... and it is provocative enough thematically to fuel hours of discussion about tradition versus modernity and how it has affected African-Americans, for better or worse... 's asking us to think about the generation gap, Christian faith versus backwoods mysticism, the grip of the past versus the pull of the present, African-American yearning for financial prosperity versus our sense of altruism & duty and complications within both sides of each coin." Roger Ebert, however, called it "too long" in a mixed review. Christopher Null called it "insanely over-rated" and gave it 2/5 stars. Entertainment Weekly'sOwen Glieberman called it "too ambitious" and said it "never finds a mood".