Hal's planned night of romance with Lois is put on hold when she has to cover for Craig, who is sick, and ends up infecting both of them with his sickness. It's then a game to see who can pretend to be healthiest the longest.
Meanwhile, Dewey brings home a dog, and with his brothers ratting him over wanting to keep it, he trains it to attack Malcolm and Reese.
Malcolm is a regular high school kid trying to navigate his way through life despite the various obstacles thrown in his way a complete misunderstanding of girls, the constant burden of masterminding plans to get himself and his brothers into or out of trouble, and a miserable job at the Lucky Aide not to mention a severe case of teen angst.
Although Malcolm has a genius IQ, he can't seem to make sense of the opposite sex, much less his embarrassing family. Lois is the outspoken, opinionated mom, who still manages to rule the roost even though her boys are growing wise to her crafty ways. Hal, a dad who is just a bumbling, big kid at heart, often finds himself creating more chaos than his five boys combined.