《游仙窟》用第一人称单数，自叙旅途中在一处“神仙窟”中的艳遇。五嫂、十娘都是美丽而善解风情的女子，她们热情招待“下官”，三人相互用诗歌酬答调情，那些诗歌都是提示、咏叹恋情和性爱的。接着那“下官”就逐渐提出要求：先是要求牵十娘的素手，说是“但当把手子，寸斩亦甘心”，十娘假意推拒，但五嫂却劝她同意。“下官”牵手之后，又向十娘要求“暂借可怜腰”（搂住可爱的腰肢）；搂住纤腰之后，又要索吻，“若为得口子，余事不承望”。而接吻之后，那浪子“下官”当然就要得陇望蜀，提出进一步的请求，但是未等他明说，十娘已经用“素手曾经捉，纤腰又被将，即今输口子，余事可平章”之句，暗示既已经接过吻，别的事情都可以商量。
随着五嫂不断从旁撮合，“下官”与十娘的调情渐入佳境，他“夜深情急，透死忘生”，“忍心不得”，“腹里癫狂，心中沸乱”，最后“夜久更深，情急意密”，终于与十娘共效云雨之欢。文中描述二人欢合情景：
花容满面，香风裂鼻。心去无人制，情来不自禁。插手红交脚翠被。两唇对口，一臂支头。拍搦奶房间，摩挲髀子上。一啮一快意，一勒一伤心。……少时眼华耳热，脉胀筋舒。始知难逢难见，可贵可重。俄顷中间，数回相接。
《游仙窟》通篇以散文叙事，以韵语对话，文辞浮华艳丽，结构谨严完整，以四六骈文的形式进行创作，与变文韵散夹杂、唱白并用的形式基本一致，写得生动活泼，是最早以骈体文作传奇，标志着自六朝志怪向唐传奇的转变，内容亦自志怪转为叙人世之悲欢离合，在汉族小说发展史上有重要意义，有人称之为“新体小说”。
人们早先所熟知的唐代传奇大都是开元天宝以后的作品，是用比较整洁的古文写成的。而《游仙窟》出现时，骈文还在盛行，因此，它的叙述语言大量使用骈偶句式，颇有汉魏六朝辞赋的韵味，而且人物对话，亦大量以诗歌代之。这种特殊的体制为中国小说发展史研究提供了可贵的“化石”标本。从中国小说的发展史来看，《游仙窟》一书为中国小说的开山之作。
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