The book is divided into five parts. The first is a definition of sf and fantasy, with references going all the way back to the beginning of the genres, before works we now classify separately were thought of as anything but "fiction." Card is very thorough and gives a reading list of "the basics" which he admits is still far less than complete.
Third, Card discusses the art of crafting your story. This is the section of the book where I feel he has the most to offer. Helpful to me was his information about which characters should be main characters and which should be viewpoint characters, which is something I struggle with. (Card discusses this much more in depth in Characters & Viewpoint, which I have not read, but, be assured it is on the list.) He points out that the main character is not necessarily the protagonist, and neither one is necessarily the viewpoint character. I think this is an important distinction, since it can be so easy to default to all three being the same in storytelling. Card also discusses a way of classifying stories, called the MICE quotient, whereby a story is either primarily about its milieu (setting), idea that it discusses, character(s), or event. He also claims never to have read a single prologue in a book he was reviewing! He feels that prologues are a waste of paper and ink for event stories. I've always liked prologues, I feel like they give you a flavor of the meat of the story without having to invest the time it takes to read 100 pages.
The fourth section of the book discusses the art of writing itself. Card uses an example to show how to say an enormous amount to the reader in only a single sentence. He also points out that when you use a metaphor in speculative fiction, there is the danger that your audience might take you literally. I had never thought of this! I tend to favor similes in description and let my characters make metaphors in dialogue, but it makes complete sense.
The final section of the book is, unfortunately, the most out of date. Card discusses how to get published and stay successful, largely colored by his own experience and the trends at the time of publication. He was first published in short fiction and then moved on to longer pieces. The world wide web was dipping its toes in to the pool of ubiquity at the time, so Card describes physically mailing out query letters and manuscripts. This, at the very least, should give you some appreciation to how much on the cost of printing and postage alone an aspiring author had to invest "back in the day." He also talks about agents, editors, classes and workshops, conferences, professional organizations, and a few other sundry aspects of the life of a professional author.
I have to say I was a bit disappointed in this book. I had heard on podcasts and read on blogs how great a teacher of writing Card was, and I was hoping this book would have the secret recipe I was looking for. However, I think I was disappointed because there was very little that was new to me in the book. Those same authors that had learned from him had already taught me many of those same lessons. If you have never written any speculative fiction and want to get your feet wet, this book would be a great instructor. This book would be great even if you are merely studying sf and fantasy. However, if writing has been your long-time hobby (or method of employment, you lucky duck), then you may not get as much out of it. Not to say that you shouldn't read it, but that you shouldn't go into it as I did.
I'd like to end with a few of my favorite quotes from the book:
"...mistakes are often the beginning of the best ideas. After all, a mistake wasn't planned. It isn't likely to be cliche. All you have to do is think of a reason why the mistake isn't a mistake at all, and you might have something fresh and wonderful, something to stimulate a story you never quite thought of that way before." - p. 29
"I firmly believe that a good storyteller's education never ends, because to tell stories perfectly you have to know everything about everything. Naturally, none of us actually achieves such complete knowledge - but we should live as if we are trying to do so. - p. 61
"Characters who are powerless aren't likely to be doing anything terribly interesting." - p. 67
"To date, SFWA seems to have had far fewer cases of bodily assault than, say, the eighteenth-century English literary crowd, so perhaps we're not so bad." - p. 132