Frankie Machine (Frank Sinatra) is a card dealer and a drug addict. (The drug is never actually named, but by all indications, it's heroin.) Frankie has just been released from a six-month stint in jail, and, now clean, is looking for a new life as a drummer in a band. However, Zero Schwiefka (Robert Strauss), who organizes the illegal poker games that Frankie used to deal for, wants Frankie back in the fold. Frankie doesn't want to deal cards anymore as that was a trigger for his heroin habit, but his needy wife Zosh (Eleanor Parker), who is in a wheelchair after Frankie crashed their car while driving drunk, wants the easy money. Frankie's old girlfriend Molly (Kim Novak) is much more supportive of Frankie's hopes to go straight.
Schweifka winds up getting Frankie chucked in jail for shoplifting, and after bailing Frankie out, gets Frankie to go back to dealing cards. Zosh—who has a dark secret of her own—badgers Frankie and hassles him about money and discourages him from making something of himself as a drummer. The local heroin dealer, Louie (Darren McGavin), is trying to get Frankie back on heroin. Finally Frankie cracks under the strain and starts using again. Tragedy ensues.
While drug use had been used for comedy as far back as 1916 and The Mystery of the Leaping Fish, and marijuana was demonized in the 1930s by ridiculous B-movies like Reefer Madness, this film was one of the first Hollywood productions to deal with drug addiction in a serious manner.
- Adaptational Ugliness: In the novel, Vi is attractive and in her 30s. Here, she's played by Doro Merande, who was 63 at the time and had a long career as a character actress specializing in plain Jane types.
- The Aggressive Drug Dealer: Louie the heroin dealer is awfully aggressive in trying to get former addict Frankie to use again. Justified in that Louie is also involved with a lucrative illegal underground poker game, Frankie is a skilled dealer, and the heroin is a means of control to bind Frankie to Louie and get him into the poker game. Notably, not only is he an aggressive drug dealer he's a full-service drug dealer, actually administering the injections himself rather than just selling Frankie some dope.
- The Alcoholic: Molly seems to be drawn to men with substance abuse problems. Johnny, the man she hooked up with after Frankie went to jail, is a drunk.
- Bittersweet Ending: Frankie still doesn't have a job after blowing his audition, and Zosh dies tragically. But it's suggested that he might have finally kicked heroin, and he might have a future with Molly.
- Cigarette of Anxiety: When the cravings for heroin get so bad that Frankie's hands start shaking, he has to leave the card game for a nervous smoke.
- Comforting Comforter: Frankie very carefully tucks Molly in.
- Creator Cameo: Most of the musicians in Frankie's audition scene are the actual Jazz players who appeared on the soundtrack, with legendary horn player/arranger Shorty Rogers getting a few lines as the bandleader.
- Creator In-Joke: A billboard for Preminger's previous film Carmen Jones is visible at one point.
- Disney Villain Death: Twice, with Louie getting pushed to his death over a staircase, then Zosh fatally careening off a fire escape of the boarding house at the end.
- Double-Meaning Title: Frankie is called The Man with the Golden Arm because of his skills in dealing cards, but he also shoots heroin into his arm, which proves quite "golden" for his supplier Louie.
- Drugs Are Bad: They are, they are very bad. The scene with Frankie trying to quit cold turkey and going through withdrawal still packs a punch today.
- Establishing Character Moment: Louie is established as a first-class scumbag when, at a bar, he forces a pathetic drunk to dance for a drink.
- Family-Friendly Stripper: Well, it was the 1950s. The girls at the strip club seem to be content with dancing in a bra-and-girdle ensemble.
- Femme Fatale: At first you think Zosh is the good girl in Frankie's life, and Molly will lead him down a dark path, but the final act establishes that Zosh is actually the Femme Fatale. You can also make a case for Louie playing an Homme Fatale role in the story.
- Have a Gay Old Time: When Louie finds out Zosh can walk, he thinks she has a scam going. He says "Let me in on it, or I'll queer it for you."
- Internal Reveal: About 20 minutes in, the audience finds out that Zosh isn't paralyzed at all. She can walk perfectly well, but is pretending to be paralyzed and racked with pain to keep a guilt-ridden Frankie with her, rather than have him leave her for Molly.
- Mickey Mousing: When Frankie goes to Louie's apartment for the first time, we see Louie taking out all the heroin paraphernalia and setting it down piece-by-piece. Each time he puts something down, there's a corresponding horn blast in the score.
- Obfuscating Disability: Zosh actually being able to walk leads to the story's climax, because Louie catches her walking when he shows up looking for Frankie, then unwisely threatens to tell everyone else.
- "The Reason You Suck" Speech: Molly gives one to Frankie when he asks her for money, but her goal is to get him to finally face his addiction and realize why he's hooked on drugs to begin with.Molly: I said take it! Go on and take it all! 'Cause all that you're gonna need after that one shot, is another, and then another, and then another. Take it! Take it! Why should you hurt like other people hurt? Yes, so you had a dog's life with never a break. Why try to face it like most people do? No! Just roll up all your pains into one big hurt and then flatten it with a fix!
- Red Light District: There's dive bars and pawnshops, the streets are littered with garbage, and Molly works in a strip club (as a hostess, not a stripper). Preminger really pushes the envelope of 1950s censorship, though, when he frames the sign above a pool hall to say "OOKER".
- Rule of Symbolism: At one point, you can see a flashing sign that says DRUGS outside Molly's window.
- Smug Snake: Louie has a constant Cheshire Cat Grin, and clearly loves manipulating people to do his bidding.
- Spared by the Adaptation: In the novel, it's Frankie who accidentally kills Louie, and he ends up committing suicide.
- Sweater Girl: Molly decides to up the Fanservice a little bit by putting on the standard tight sweater and then undoing three of the five buttons.
- Sympathetic Adulterer: Frankie, cheating on his lying, manipulative wife.
- Title Drop: A gambler greets Frankie with "Are you Machine? The man with the golden arm, huh?"
- Toxic Friend Influence: Toxic wife influence, as Zosh manipulates Frankie and steers him back into the bad habits that led him to heroin the first time.
- What the Hell Is That Accent?: Eleanor Parker gives Zosh what's presumably supposed to be a Polish-American accent, but she slips in and out of it throughout her performance.
- Your Mom: One of the other tenants in the boarding house mixes this with Country Matters. When the cranky landlord says she has to do what he says, she shoots back "Your mother's icebox, I do what you say!"