
The film, set in California, opens with Cosmo Vittelli (Ben Gazzara) making the final payment on a longstanding gambling debt to a sleazy loanshark (played by the film's producer Al Ruban). It turns out, that the person who Vitelli had just repaid his debt to is associated with the mob and sets up Vitelli by bringing larger fish gangsters to Vittelli's artistic club. Vitelli and Mort (Seymour Cassel) share talk and conversation about the club ownership business, Vitelli orders Mort and his party bottles of Dom Perignon. Mort then sets Vitelli up by offering an open invitation to gamble at the mobster's club, all expenses paid, other than the gambling gains or losses. To celebrate his long-anticipated freedom, cabaret owner Vittelli has an expensive night out with his three favorite dancers ("Margo", "Rachael" and "Sherry"). The evening culminates in a poker game in which Vittelli loses $23,000 (2016, $97,500 equivalent) returning him to the debtor's position he had just left. Using the debt as leverage, his mob creditors coerce him into agreeing to perform a "hit" on a rival. Vittelli is led to believe that his target is a small-time criminal of minor consequence, the Chinese bookie of the film's title; but in fact, he is the boss of the Chinese mafia, "the heaviest cat on the West Coast." Vittelli manages to kill the man and several of his bodyguards, but is severely wounded before escaping.

In addition to the potentially fatal gunshot wound he sustains, Vittelli comes to realize that his assignment was a set-up: that his mob employers double-crossed him and had no expectation he would survive his debut as a hitman. Vitelli loses his "black" and "beautiful" girlfriend, Rachel (Azizi Johari) and the support of her loving mother due to the chaos and the gunshot wound he refuses to acknowledge. It also becomes evident that due to Vitelli's direct combat experience in Korea and his snap execution of the West Coast Chinese gangster leader and his bodyguards, that, in fact, his Italian gangster foes are "amateurs" in comparison to him. Vitelli fatally shoots Mort but Mort's mob companion is left in a warehouse firing off rounds into warehouse walls, hunting for Vitelli. Forced into a corner again, Vittelli manages to kill or elude his assailants, but the film ends with no indication of whether Vittelli will survive his ordeal, as the show at his club goes on. Vitelli (with a bullet in his side) informs his artists that Rachel has left the production team and has the "flu" or has moved on to "bigger and better things", never accounting for the lost love potential between Vitelli, Rachel and her mother who said she loved Vitelli but wanted him out of her house until he sought medical attention to remove the bullet.
Ben Gazzara as Cosmo Vittelli
Timothy Agoglia Carey as Flo
Seymour Cassel as Mort Weil
Robert Phillips as Phil
Morgan Woodward as The Boss
John Red Kullers as The Accountant
Al Ruban as Marty Reitz
Azizi Johari as Rachel
Virginia Carrington as Mama
Meade Roberts as Mr. Sophistication
Alice Friedland as Sherry
Donna Marie Gordon as Margo Donnar
Haji as Haji
Carol Warren as Carol

The film's original release, at 135 minutes in length, was a commercial disappointment and the film was pulled from distribution after only seven days. At a May 17, 2008 George Eastman House screening in Rochester, Ben Gazzara said he 'hated' the original cut; 'it's too long', he had told Cassavetes.

Eventually, Cassavetes decided to re-edit the film, and it was re-released in 1978 in a new 108-minute cut. The 1978 version is the one that has been in general release since that time, though both versions of the film were issued in The Criterion Collection's John Cassavetes: Five Films box set, marking the first appearance of the 1976 version since its original release.

True to Cassavetes' form, the 108-minute version is not just a simple edit of the 135-minute version. The order of several scenes has been changed, there are different edits of a few scenes, and there are a few segments unique to the 108-minute version. The bulk of the cutting in the 1978 version removed many of the nightclub routines that were in the 1976 version.
The Killing of a Chinese Bookie received mixed reviews upon its initial release, but has developed a cult following since. Jay Cocks of Time gave the film a positive review, explaining, "When John Cassavetes makes a gangster movie, you can be sure only that it will be like no other. A film maker of vaunting, demanding individuality, Cassavetes is like a jazz soloist, an improviser who tears off on wild riffs from a basic, familiar melody." Vincent Canby of The New York Times thought differently, saying, "The Killing of a Chinese Bookie is like the last three of the director's films (A Woman Under the Influence, Husbands and Minnie and Moskowitz) in the way it resolutely refuses to come to a point strong or interesting enough to support the loving care that's gone into its production, particularly on the part of the actors."
Review aggregator Rotten Tomatoes reports that 77% of 22 film critics have given the film a positive review, with a rating average of 6.4 out of 10.