The collection consists of manuscripts, correspondence, family documents, and other papers of novelist Madison Smartt Bell. The earliest item in the collection is a datebook from the year 1979, the year of Bell's graduation from Princeton University. The manuscript material includes an early typescript of Bell's first novel Washington Square Ensemble (1983), as well as notebooks, drafts, galleys and proofs of Doctor Sleep (1993), All Souls' Rising (1995) and later works. Also included in the manuscript material are variants for an unpublished screenplay about an earthquake in California, entitled The Safety Net, drafts of articles and reviews, transcripts and/or cassettes of four interviews by Bell of others, and miscellaneous writings, fragments and notes, among which is a series of xeroxed images by printmaker Jean de la Fontaine with blurbs by Bell (unpublished?).

The bulk of the correspondence and of the collection is personal mail, dating from 1981 to 2011, organized chronologically and therein alphabetically, with separate folders for correspondents with the most numerous letters. Among his most frequent correspondents are his former Princeton creative writing teacher George Garrett, filmmaker Alexis Roshuk, fellow novelists Tom McGonigle, Jill McCorkle, and Elizabeth Moore, and students Amy Homes, Marcia Golub, Carolyn Chute, Ellen Geist, and Darcey Steinke. This series preserves everything from post-it notes and Christmas tags to post cards and full-length letters. There are also three boxes of business correspondence, including agent correspondence, dating from Bell's first exchanges with Jane Gelfman in 1981, and direct correspondence with editors and publishers. Ticknor and Fields is heavily represented, as the publisher that has brought out most of Bell's novels, though he later published with Harcourt Brace. The business correspondence also includes some drafts Bell kept of outgoing letters.

The family documents include an extensive family tree for the Smartt family, found loose among the correspondence, as well as Bell's birth certificate. The Papers of Other Persons series includes a typescript of fellow novelist Tom McGonigle's The Corpse Dream of N. Petkov (1986), as well as correspondence of Bell's wife, the poet Elizabeth Spires.

Additional materials received from the author following the original accession can be found in Series 7: Additional Papers, including manuscripts and correspondence related to his writings and other activities throughout the 1990s until 2021.