In the season four premiere, gang from Beverly Hills have graduated from high school. Naomi has spent the summer dealing with the shocking news of her pregnancy and quickly discovers she doesn’t have the status at college that she did in high school. Annie receives some unexpected news that keeps her in town, while Liam returns from his summer away ready to commit to Annie. Dixon finds himself without a roommate or a place to live, while an unexpected visitor tests Navid and Silver’s relationship after they move in together. Adrianna comes back to town looking for redemption, which she soon learns will be hard to earn back. Ivy and Raj struggle to deal with Raj’s health getting worse, while Teddy struggles with coming out to his family.

Navid surprises Dixon with some studio time to apologize for messing things up with a music producer, where Dixon feels the pressure to create a hit song. Naomi plots revenge to take down rival Holly and her sorority during the Greek games, which requires Austin's help, much to Naomi's dismay. Silver directs a disastrous commercial for Liam's bar, while Ivy feels torn between her relationship and her friends.

Liam gets offered a modeling job after an agent sees the commercial for his bar, while Annie finds herself starting to fall for an unlikely guy. During a charity talent show event to raise money for an experimental cancer treatment for Raj, Naomi is determined to win the contest in order to show up Austin's out-of-town visitor Sally. While working on his music, Dixon pushes his limits and starts spiraling out of control, which forces Adrianna to confront him.

Silver’s video of Teddy's Vegas wedding is leaked to the press, and has damaging effects on his uncle’s campaign. Liam’s modeling career is taken to the next level by Shelia and Annie is determined to help Dixon, even though the help he needs comes at a high price. Meanwhile, Ivy and Raj decide to plan for the future.

Dixon tries to pursue a relationship with a resistant Adrianna, while Ivy and Raj’s arguing takes a toll on their relationship. Liam plans a holiday dinner for the gang, and an unexpected guest shows up. Meanwhile, Naomi goes to extremes to prove her love to Austin.

Dixon collapses while arguing in the recording studio with Adrianna. In the hospital, they run into Liam who is with Silver to support her during a test to detect if she has the breast cancer gene. Ivy finds out Raj still has cancer and is in the hospital, while Annie meets a new guy Caleb and discovers he is a priest.