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桃姐（叶德娴 饰）是侍候了李家数十年的老佣人，把第二代的少爷罗杰（刘德华 饰）抚养成人。罗杰从事电影制片人，五十多岁了仍然独身，而桃姐也继续照顾罗杰，成为习惯……一日，桃姐如常到街市买菜，回寓所煲汤、做好满桌的饭菜，在等待从内地出差回家的罗杰，桃姐看着窗外的街景打发时间 ，不知不觉间却竟昏迷在地上……桃姐醒来时发现自己身在医院，桃姐是中风了！一边手臂不能活动自如，必须利用物理治疗尽量恢复活动能力。 罗杰在百忙工作中为桃姐找合适老人院，期间巧遇昔日电影拍摄认识的草蜢哥（黄秋生 饰），桃姐出院来到老人院，环境陌生，院友怪异，桃姐强装镇定。罗杰工余常到老人院探桃姐，主仆闲话家常一如母子，仍保持互相揶揄调侃习惯，桃姐嘴硬心甜，院友羡慕。 罗杰特意带桃姐参加电影首映礼，桃姐首次刻意打扮准备，取收藏已久的名贵衣服出发赴会；首映礼上桃姐大开眼界，更终有机会见到电影明星，桃姐感叹自己有生之年已然无憾……
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