Set in the Bronx's Little Italy, Sally Boy tells the story of Salvatore Scalise and his bloody rise to power in the New York underworld. As a youth, Sal was a member of the Golden Guineas, a feared street gang made up of the sons of Italian immigrants. He learns how to fight, to value a trusted friend, and to respect the sacred code of the streets. Sal's journey is passionate and dangerous, leading him from the bedrooms of the most desirable women to the perilous jungles of Vietnam.

Back in New York, Sal reaches out to a childhood friend who has graduated to Mafia soldier. Impressed with Sal's fighting skills, the Mirragio crime family embraces him. However, when ordered to murder his best friend, Sal has no choice but to commit the unthinkable. Consumed with rage, Sal rebels, resulting in his humiliating expulsion from the Mirragio's ranks. In retaliation, Sal forms his own crew and seeks revenge. Using his military training and a savage capacity for killing, Sally Boy sets out to slaughter the Mirragio family and seize control of the Bronx drug trade.