As is usually the case with first-person narratives, there are multiple settings to the story. The action of the recounted tale takes place in the house the narrator shares with the old man. At the same time, the narrator is telling the story from either a prison or an insane asylum where he has been incarcerated.

But even more importantly, the setting is actually inside the obsessed mind of the narrator himself, for the crucial climactic event of the story—his hearing the beating of the dead man's heart— take place solely within his own tortured imagination.