Jud ended up showing Louis and his family the Pet Cemetery, which had a sign that was spelled "Pet Sematary". Later, in the story, Ellie's cat, Winston Church, was run over. Louis then ended up resurrecting Church by using the burial ground beyond Pet Cemetery.
Sometime later, tragedy struck: Gage got run over by a truck. After Gage's funeral, Louis dug Gage up, resurrected him despite Jud's warnings, and intended to spend a couple of days alone with him after he sent both Rachel and Ellie to Rachel's parents so that he could 'make a diagnosis' and determine if Gage was himself or something else.
However, the Wendigo revived Gage, and Gage killed both Jud and Rachel. Louis then ended up killing both Church and Gage with lethal injections. Louis then decided to burn down his house. The Police came and asked questions but voiced no suspicions. Louis then buried Rachel so that she could be resurrected, proclaimed that he waited too long with Gage, and convinced himself that Rachel would be fine if he buried her earlier.
The novel ended with Louis playing Solitaire. Louis was about to deal a fresh hand when he heard his back door open. Louis then looked at his cards while footsteps approached. A cold hand then fell on his shoulder and Rachel, with a grating voice that was full of dirt said: "Darling."
It was unknown whether Louis survived or not (Although the film version ended with Rachel picking up a knife and moving as though she was about to stab Louis in the back).
In the 2019 remake, Louis is killed in the end and is resurrected by Ellie.