The tenth season of Kitchen Nightmares returns with a two-hour premiere focusing on two troubled Midwest establishments requiring Gordon Ramsay's expertise. Freddy's Steak House is mired in a power struggle between its manager and head chef whilst the owner faces mounting debt, whilst 4 Star Diner has become dependent on frozen ingredients and suffered reputation damage due to its owner's loss of trust among staff and customers.

At 4 Star Diner, Ramsay quickly identifies systemic problems during his inspection. The owner repeatedly makes false claims about his hands-on involvement in operations and kitchen cleanliness standards, which Ramsay disproves through direct observation. An examination of the kitchen reveals widespread sanitation failures with grease and grime accumulating on equipment including floors, fryers, and microwaves, despite the owner insisting that nightly deep cleaning occurs—claims contradicted by staff members.