Most of the episodes involve Black Jack doing some good deed, for which he rarely gets recognition, often curing the poor and destitute for free, or teaching a capitalist fat cat and his pompous colleagues a lesson in humility. They frequently end with a good, humane person enduring hardship, often unavoidable death, to save others.

Osamu Tezuka drew on his knowledge as a physician in writing Black Jack, and the manga contains frequent medical details. However, Tezuka chose to generally eschew medical plausibility in his manga: Black Jack is superhuman, regularly performing spectacular and impossible feats of surgical virtuosity, such as operating in absolute darkness completely from memory, and transplanting body parts without any risk of rejection. (However, rejection is accounted for in some anime episodes.)

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