The fourth season begins with a nice wedding of an unexpected couple and kiss at the airport for couple Bright and Hannah in Everwood.
Nina finally chooses between the two men she loves - Andy and Jake while at Delia's behest. Amy develops a new friendship with college-age student Reid (guest-star Justin Bardoni) while waiting on her mother Rose at the hospital. Also, Amy and Rose find that Rose's cancer has driven them apart rather than brought them together. Bright flirts with a new girl who might become his roommate, but is more involved in knowing what girlfriend Hannah scribbled off the postcard that she sent to him. Lastly, Ephram makes an emotional return to Everwood just in time for an unexpected wedding.
Dr. Andy Brown's seemingly perfect life was shattered when his wife, Julie, washuged in a tragic car accident. Prior to the accident, Andy was a world-famous neurosurgeon who often put his career before his family life. Now, Andy must single-handedly raise his two children, Ephram and Delia. In order to do so, Andy moved his family from New York City to the quiet, yet charming town of Everwood, Colorado.
In Everwood, Andy opened a free clinic, much to the dismay of most of the citizens. However, Edna Harper saw something in Andy that no one else saw and applied to be Andy's nurse and office manager. Andy was also well received by Irv, Edna's husband, and his new next-door neighbor, Nina Feeney. But along with the warm welcomes came the less than pleased individuals, including Dr. Harold Abbott, who forbade his wife Rose, and children, Amy and Bright to be around Andy or his children.
But regardless of such warnings, Amy quickly befriended Ephram, who instantly fell in love with her. Over the years, the two have formed a friendship, and for awhile, they even managed to be more than just friends. Ephram also formed an unlikely bond with Bright, and the two remain close friends, and recently have become roommates. Over time, Harold warmed up to Andy, and the two are now partners. However, despite the picturesque appearance of Everwood, the residents are faced with hardships and drama, including cancer, drug addiction, secret affairs, and tragic passings all while trying to live a quiet life in a small town.