The narrator, Tristram Shandy, begins the story of his life by describing his own conception. While his mother and father are having sex, his mother unexpectedly asks whether her husband “forgot to wind up the clock” (5). This interruption, Tristram speculates, may have influenced his conception. He criticizes his parents for being so careless at such an important moment. If they had focused on the task at hand, he suggests, then their son might not have grown up riddled with a “thousand weaknesses” of the body and mind. He discusses different theories of human conception, which he explains afterward were his father’s theories. Tristram promises to provide a more detailed explanation of his birth soon, but he wants to inform the audience about his “opinions” first. He knows that he is an unconventional narrator, but he asks for the audience’s patience, which will allow him to tell his own story in his own way.

Tristram tells the long, rambling story of the local midwife. She has a license to practice, and Tristram satirizes the language used in the document. Next, he introduces Pastor Yorick. He compares Yorick to his namesake in Hamlet as well as the title character in Don Quixote.