Lanark is eventually swallowed by a mouth in the earth, and awakes in the Institute, a sort of hospital which cures patients of their diseases but uses the hopeless cases for power and food. Lanark begins to associate with a group of twenty-somethings to whom he cannot fully relate and whose mores he cannot understand, and soon begins to suffer from dragonhide, a disease which turns his skin into scales as an external manifestation of his emotional repression. He soon arrives in Unthank, a strange Glasgow-like city in which there is no daylight and whose disappearing residents suffer from strange diseases, orifices growing on their limbs and body heat fading away. He has no memory of his past and picks his name from a strangely familiar photograph on the wall. In Book Three, a young man awakes alone in a train carriage. In the Epilogue, the author explains this by saying that 'I want Lanark to be read in one order but eventually thought of in another', and that the epilogue itself is 'too important' to go at the end. Lanark comprises four books, arranged in the order Three, One, Two, Four (there is also a Prologue before Book One, and an Epilogue four chapters before the end of the book).

In 2008, The Guardian heralded Lanark as 'one of the landmarks of 20th-century fiction.' Plot summary The book, still his best known, has since become a cult classic. Lanark won the inaugural Saltire Society Book of the Year award in 1982, and was also named Scottish Arts Council Book of the Year. Its publication in 1981 prompted Anthony Burgess to call Gray 'the best Scottish novelist since Walter Scott'. Written over a period of almost thirty years, it combines realist and dystopian surrealist depictions of his home city of Glasgow. Lanark, subtitled A Life in Four Books, is the first novel of Scottish writer Alasdair Gray.

Lanark alasdair gray review