The film's framing device involves Police General Yevgraf Zhivago (Alec Guinness) searching for the love child of his brother, poet and doctor Yuri Zhivago (Omar Sharif), and his mistress Larissa ("Lara") Antipova (Julie Christie); Yevgraf believes a young woman named Tonya Komarovskya (Rita Tushingham) working on a dam project, (referred to as "The Girl" in the credits) may be his niece. Yevgraf narrates the story for her, periodically appearing in it, though rarely interacts with any other characters in the flashbacks.
Yevgraf tells the girl the story of his brother's life. Yuri's parents died when he was very young—the opening scene is the burial of Yuri's mother—leaving him only a balalaika, and he went to live with the Gromekos—Alexander (Ralph Richardson) and Anna (Siobhán McKenna)—and their daughter Tonya (played as an adult by Geraldine Chaplin), whom Zhivago later marries. Gromeko was a retired professor living in Moscow, and so Zhivago is able to enter medical school, studying under Professor Boris Kurt (Geoffrey Keen). Though he is already a poet of some renown, Yuri does not think that he can support himself as a poet and decides to become a doctor. Lara, meanwhile, lives with her mother (Adrienne Corri), a dressmaker who is being "advised" by Victor Komarovsky (Rod Steiger), a lawyer with political connections, who had also been the friend and business partner of Zhivago's father.
Lara is friends to Pasha Antipov (Tom Courtenay), an idealistic young man, who is wounded by a saber-wielding Cossack during a peaceful protest, leaving a conspicuous scar across his cheek which would mark him for life. Pasha allowed the wound to scar, partly out of machismo and partly because his low social status does not entitle him to medical attention. That same evening, Komarovsky had taken Lara to a posh restaurant (in lieu of her mother, who is ill) and then seduced her.
Lara becomes more deeply involved with Komarovsky, until her mother finally discovers their affair and tries to kill herself by swallowing iodine. Komarovsky discovers her and summons help from Kurt and his assistant Zhivago, who sees Lara for the first time.
When Pasha, now a dedicated Bolshevik, tells Komarovsky that he intends to marry Lara, Komarovsky tries to dissuade Lara from doing so, and then rapes her. After he points out to Lara that her enthusiastic cooperation with the act is proof that she is nothing but a slut. In revenge, Lara takes an illegal pistol she had been holding for Pasha, tracks Komarovsky down to a Christmas party (where Zhivago and Tonya announce their engagement) and shoots and wounds him (in the arm). Kamarovsky insists that she be released and shouts, "get her out of here"; Lara is escorted out by Pasha, who had followed her into the party, and who then learns of Lara's seduction and infidelity.
The movie then jumps ahead to August 1914: World War I. Yevgraf enlists, intending to subvert the war effort for the party in order to help start the Revolution among a defeated people; Yuri (now married to Tonya) and Professor Kurt become medical officers; and Pasha joins a volunteer regiment as well, becoming one of the only men that the soldiers trust. Pasha is supposedly killed in a battle on the Eastern Front, while Lara joins as a nurse in order to look for him as the Revolution breaks out and the Russian army begins to desert en masse.
Travelling with a group of deserters, Lara meets Zhivago, who is with a column of replacement troops marching to the front; the replacement soldiers mutiny, kill their officers, and join the deserters, and Zhivago enlists the help of Lara to tend to the wounded. The two manage a makeshift hospital in a country estate for the remainder of the war and are parted at war's end.
Yuri returns to Moscow, finding that his Aunt Anna is dead and that the Gromeko's house has been apportioned by the revolutionary government to accommodate 20 or 30 other people. Yuri meets his son Sasha for the first time, and resumes his old job at the local hospital, but is furious that his family is lacking in basic fuel and food. One night, while he tries to steal wood from a fence for his family stove, he is spotted by Yevgraf who follows him home. Yevgraf informs Zhivago that his poems have been condemned by the government as antagonistic to the new ideology, putting their whole family at risk for collective punishment. He helps arrange for rail passes for their transport to the Gromeko estate at Varykino, in the Urals.
Zhivago, Tonya, Sasha, and Alexander board a heavily guarded cattle train which includes a detachment of labor conscripts—including the hot-headed anarchist intellectual, Kostoyed Amoursky (Klaus Kinski)—and a large contingent of Red Guard soldiers. At one point, the train passes through the village of Mink, which has been shelled by Red forces commanded by a People's Commander Strelnikov; at the end of Act One, Strelnikov is revealed to be Pasha. While the Urals train is stopped, Zhivago wanders away from the train, listening to the sound of a waterfall, and stumbles across Strelnikov's armored train sitting on a hidden siding. He is arrested and brought to Strelnikov (recognized by him as Pasha) as an suspected assassin. After a tense conversation, Yuri reveals that he saw Strelnikova at the Christmas party; Strenikov tells Yuri that Lara is alive in the town of Yuriatin — which is currently occupied by forces of the White Army — and lets Zhivago go back to his train (and family). A casual comment by the guard taking him back to his train reveals that most people interrogated by Strelnikov end up being shot.
Zhivago's family arrives at Varykino but finds their main house has been boarded up with a sign indicating confiscation by the Soviet regime, aka "people". Out of fear of being executed as "counter-revolutionaries", they desist from breaking into their own house. However, they decide to occupy the smaller guest cottage. The family lives a mundane life until the next spring, when Zhivago goes into Yuriatin and discovers that Lara is the local librarian. The two reacquaint themselves and begin a sexual relationship. Zhivago is torn between Tonya and Lara, until Tonya becomes pregnant; Yuri travels to Yuriatin and breaks off his affair with Lara, only to be captured and conscripted into service by Red partisan troops under Liberius (Gerard Tichy) while riding back to Varykino.
After serving with the Partisans for nearly two years as a medical officer, Zhivago deserts, only to find that his family has left Russia and emigrated to Paris; he goes to Lara's home in Yuriatin, and is welcomed by Lara. The two renew their relationship, but Komarovsky arrives one night and informs them that they are being watched by the Bolsheviks, due to Lara's marriage to Strelnikov (who is now out of favor with the government). Komarovsky offers Yuri and Lara his help in escaping, but they refuse; the two go with Lara's daughter, Katya, to the Varykino estate, which has been left open and is frozen inside. Yuri begins writing the "Lara" poems, which would later make him famous but incur government displeasure. Komarovsky reappears, telling Yuri that Strelnikov has killed himself while being walked to his execution, and that Lara is now in immediate danger. She was left unarrested only to lure Strelnikov into a trap. Zhivago scoffs at that, and Komarovsky advises him that to the contrary, Strelikov was arrested on the open road only five miles from Varykino. Yuri agrees to send Lara away with Komarovsky who has been appointed as Minister of Justice in Mongolia, but Yuri remains behind.
Years later, almost an invalid, Yuri retuns to Moscow, where Yevgraf gets him a hospital job and buys him some clothes. While riding a tram to his first day at work, he sees a woman he recognizes as Lara, forces his way off the tram, and runs after her. He suffers a fatal heart attack in the street; she walks on without seeing or hearing him. Lara comes to his funeral, surprised and saddened by his death. Lara had become separated from her and Yuri's child when revolution broke out in Mongolia, and enlists Yevgraf's help, which is unavailing. After looking over hundreds of orphans, she gives up. By that time, Zhivago's work has been allowed to circulate due to change in party policy and his burial has been widely attended, despite being denied a state funeral.
At the beginning of the film, Zhivago's mother dies (the film opens at her funeral) and he inherits her balalaika. His adoptive father tells him that his mother had a gift. The theme of artistic talent is repeated throughout the film, as Zhivago becomes a poet of great renown. At the end of Yevgraf's story, the girl ends the meeting, denying that she is Yevgraf's niece, and leaves with her boyfriend. Yevgraf notes that the girl has a balalaika on her back. After being informed that the girl plays well without having had any lessons, Yevgraf says about her talent: "Ah, then, it's a gift." He is now convinced that the girl is indeed the daughter of Yuri and Lara, lost in Mongolia, thus bringing a coda to the framing device.
Since the book was banned in the Soviet Union, the movie was filmed largely in Spain over ten months, with the entire Moscow set being built from scratch outside of Madrid. Most of the scenes covering Zhivago and Lara's service in World War I were filmed in Soria, as was the Varykino estate. Due to uncooperative weather in Spain, some of the winter sequences were filmed in Finland, mostly landscape scenes, and Yuri's escape from the Partisans. Winter scenes of the family travelling to Yuriatin by rail were filmed in Canada.
The "ice-palace" at Varykino was filmed in Soria as well, a house filled with frozen beeswax. The charge of the Partisans across the frozen lake was filmed in Spain as well; a cast iron sheet was placed over a dried river-bed, and fake snow (mostly marble dust) was added on top. Most of the winter scenes were filmed in warm temperatures, sometimes of up to ninety degrees Fahrenheit.
It should be noted that most of these cuts were made or advocated by David Lean; screenwriter Robert Bolt's original screenplay dealt with the political/historical aspects of the book in a more in-depth, if still abbreviated manner. The scenes of Yuri's service with and escape from the Partisans included scenes where Liberius executes mortally wounded Partisans. Zhivago's horse, after the escape, is killed for food by a group of homeless children, and Zhivago comes across a group of children who are, it is hinted, cannibalizing the bodies of their parents.
Perhaps the biggest change in characterization is of the Pasha character. In the book, Pasha is a revolutionary dilettante and an apolitical military leader; his ultimate fall from grace is because he is not a true Bolshevik. In the film, however, Bolt depicts him as a hardcore Bolshevik from the beginning, though his character still develops into a more ruthless individual over the course of the story. Bolt wanted to include the book's scene where the disgraced Strelnikov returned to Varykino, met with Zhivago, and then committed suicide; Lean, however, decided to cut it out, and Strelnikov's fate was dealt with through dialogue spoken by Komarovsky.
The present-day subplot involving Yevgraf's interview of The Girl several decades after the story's main events was added as a narration/framing device to help move along the story. Omar Sharif later joked that it was added to reassure the audience that Yuri and Lara would ultimately get together, even though the audience would have to wait until two hours into the film for it to happen.
Lean's production of Zhivago has stood the test of time. The film left an indelible mark on popular culture and fashion, and to this day remains an extremely popular film: Maurice Jarre's haunting score - particularly Lara's Theme - became one of the most famous in cinematic history. Over the years, the film's critical reputation has gained in stature, and today Zhivago is considered to be one of Lean's finest works and is highly critically acclaimed, along with Lawrence, Brief Encounter and Bridge on the River Kwai.
As with the novel itself, the film was banned in the Soviet Union. It was not shown in Russia until 1994.