How Does House End? Revisiting the Show's Shocking Finale, 20 Years After It First Premiered

Warning: Spoilers for House ahead!

It's not surprising that House was a hit: The medical procedural drama was simultaneously a take on Sherlock Holmes, with the titular Gregory House, M.D. (Hugh Laurie) taking on medical diagnostic mysteries at the fictional Princeton-Plainsboro Teaching Hospital in New Jersey instead of murders in London, complete with the aid of his best friend, Dr. James Wilson (Robert Sean Leonard) taking on the role of Holmes' John H. Watson.

Apart from being a mastermind at diagnostics, House earned a reputation as a cantankerous, troublemaking character who believes that "everybody lies" — and that's largely what made him memorable on- and off-screen.

"I love House," Hugh Laurie previously told Entertainment Weekly ahead of the series finale in 2012. "He's immensely funny, imaginative — and some bad things too. Basically he's on the side of the angels without necessarily being an angel."

The drama, which aired for eight seasons from 2004 to 2012 on Fox, followed House and his team through professional and personal trials and tribulations, which ran the gamut from marriages and breakups to terminal illnesses, pranks, revenge and even jail time. These elements led to one of the most surprising twists in TV history.

Here's everything to know about the House ending, including a look at the titular character's decisions in the show's final moments.

How does House end?

In "Holding On," the penultimate episode of House, Dr. Eric Foreman (Omar Epps) surprises House with season hockey tickets, and House flushes the tickets down different toilets throughout the hospital.

The prank inadvertently backs up the entire hospital sewage system, destroying an MRI machine and causing a hospital-wide power outage. Authorities eventually find tickets with House's name and fingerprints on them in an outdoor drainpipe, meaning House will likely be charged with vandalism and have to go back to jail.

The series finale, "Everybody Dies," opens with House waking up in an abandoned, burning building surrounded by empty liquor bottles and drug paraphernalia next to a dead patient (James LeGros) who overdosed. Throughout the episode, House hallucinates conversations with past characters, both living and dead.

In a flashback to before the fire, House urges Foreman to tell his parole board that he needs to be at the hospital for five months (the same length as Wilson's life expectancy). After Foreman reluctantly agrees, House asks Wilson to take the fall for the flooding, but he refuses.

Later, Wilson and Foreman search for House after not hearing from him in days. At House's apartment, they check his phone and notice he called his psychiatrist, Dr. Darryl Nolan (Andre Braugher). Soon, Wilson and Foreman interrupt one of Nolan's therapy sessions, who hints that House may have relapsed.

Remembering that House's most recent patient was addicted to heroin, they eventually find an abandoned building. Wilson and Foreman see what appears to be House in the doorway of the structure, which then explodes.

The next day, House's team arrives at the site of the fire and debates whether he survived. Dr. Chi Park (Charlyne Yi) remains optimistic, but Dr. Chris Taub (Peter Jacobson) notes that firefighters removed a body from the property. At the hospital later, a coroner confirms that House died in the fire, having identified his body with dental records.

At House's wake, different people in his life take turns speaking about the impact he had on their lives and careers, including Wilson, Dr. Robert Chase (Jesse Spencer), Dr. Allison Cameron (Jennifer Morrison), Thirteen (Olivia Wilde) and House's wife Dominika (Karolina Wydra).

Wilson's eulogy starts with praise for House as a healer but ends in fury. Wilson mentioned House's tendency to "mock" everyone and his "insane quest for truth." When he concluded his speech, calling House "selfish," he received a text in all-caps that read, "Shut up you idiot."

The scene flashes to Wilson pulling up outside an apartment with House sitting on the front steps. It turns out that House switched dental records with his dead patient and escaped through the back of the building. He came up with the plan to fake his death to avoid going to jail for the hockey ticket prank and spend the time with Wilson instead.

"You're destroying your entire life. You can't go back after this. You'll go to jail for years. You'll never be a doctor again," Wilson says. "I'm dead, Wilson. How do you want to spend your last five months?" House quips.

In the following scenes, viewers get a glimpse of the diagnostic team's futures: Chase is now the head of the Princeton-Plainsboro diagnostics team, overseeing Adams and Park. Taub is seen out to dinner with his estranged wife Rachel (Jennifer Crystal Foley), their daughters and girlfriend Ruby (Zena Grey). Cameron works in an emergency room, where she's spotted looking at a photo of her time with House and the diagnostic team before her husband comes to pick her up with their baby.

Meanwhile, Foreman is still the head of Princeton-Plainsboro, who finds House's hospital staff ID under a table leg in his office and chuckles to himself.

In the final scene of the series, House and Wilson ride motorcycles together into the sunset.

Who does House end up with in the end?

Who else? House ends up with Wilson, his best friend.

"Ultimately, it’s House making a sacrifice — and yet not making a sacrifice," House, M.D. creator David Shore told Entertainment Weekly in 2012. "It’s House being with the person he should be with, in some ways."

He added, "It’s not too sweet because it’s Wilson dying and House screwing everything up — and yet it’s Wilson and House riding into the sunset. And it’s House assessing his whole life for 40 minutes before that ... It just felt like the right tone and the right story."

Why didn't Cuddy appear in the House finale?

Dr. Lisa Cuddy (Lisa Edelstein) was one of House's main love interests and played a major role in the series from season 1 through season 7.

When asked if actress Lisa Edelstein was approached to make a cameo in the series finale, creator Shore told Entertainment Weekly, "I wanted her to come back, but we weren't able to make that happen."

In 2011, Deadline reported that Edelstein left the series due to contract disputes after she and another cast member were reportedly asked to take pay cuts for the final season.

Why does Wilson have 5 months to live?

Wilson is diagnosed with stage II thymoma, a rare form of cancer of the thymus gland, located behind the breast bone. Wilson first reveals his diagnosis to a stunned House in season 8, episode 18, titled "Body and Soul."

In Episode 19, "The C Word," Wilson's own oncologist recommends radiation therapy before surgery to avoid putting too much stress on his immune system, noting that he previously recommended the same treatment plan to his patients.

Wilson rejects the plan, saying that because his cancer has metastasized, he wants a more aggressive combination of radiation and chemotherapy. He consulted with four other doctors, who all recommended radiation followed by surgery.

House discovers that Wilson is planning to administer his own chemotherapy treatment in such a high dose that it may be lethal, and he agrees to help administer Wilson's chemotherapy.

"When Wilson decides to try a dangerous course of chemo, House argues against it, tells him he’s crazy, that he'll kill himself. And then, as he’s leaving, he stops in the doorway and says, over his shoulder, 'We’ll do it at my place,' " Laurie recalled to the Los Angeles Times.

The actor continued, "I honestly did not see that coming. It's such a lovely declaration of love and companionship. I thought House would just walk away at that point, but when I read it, I realized 'No, this is what he would do.' Logical, yet surprising."

At the conclusion of episode 20, titled "Post Mortem," it's revealed that the aggressive treatment failed.

House tries to convince Wilson to undergo radiation and surgery, but Wilson says he would rather live for five good months than for several years in and out of hospitals.

What happens to Wilson at the end of House?

When Wilson's aggressive chemotherapy treatment fails, he chooses to live out his final five months with House instead of undergoing radiation for his cancer and surviving for a few more years. The pair travel together on motorcycles after House fakes his own death.

Actor Robert Sean Leonard reflected on House and Wilson's friendship in an interview with The New York Times and shared his thoughts on why the two characters get along.

"People say, why is my character friends with him? And I say, why do you watch him?" he said. "He's antisocial; he's brilliant; he's frustrating; he's irreverent; he plays jazz piano; he drinks bourbon; he's very wise. What's not to like?"

Did Foreman know House was alive?

At the conclusion of House, Foreman is still the dean of medicine at Princeton-Plainsboro Teaching Hospital.

After House's funeral, Foreman finds House's ID holding up a table leg he'd been trying to fix previously. He laughs to himself, with the gesture implying that he knows House is alive. So, while Forman may not have known at the time of the fire and memorial, it seems he eventually catches on to House's antics.

Did Cuddy go to House's funeral?

Cuddy didn't attend House's funeral, as actress Edelstein didn't return for the series finale. In the season 7 finale, House drove a car into Cuddy's living room while she was inside with her family, including her baby.

Three years after House ended, Edelstein told TVLine in 2015 that she thinks her character's exit from the series was reason enough for Cuddy not to return to eulogize House after his death.

"I don't think that show was about happy endings. And the truth is, if someone drives a car through your living room you should do what I did and get the f--- out of town," she joked.

Edelstein continued, "He drove a f------ car through her living room. With the baby and family inside. That's crazy. You file a police report and you leave — and you don't come back for the f------ [series] finale."

Is there a House spinoff?

So far, there haven't been any spinoffs or reboots of House. However, Laurie did play a doctor again in the Hulu series Chance.

Like House, the title is Laurie's character's last name, but the similarities pretty much end there: Laurie stars as Dr. Eldon Chance, a forensic neuropsychiatrist who gets caught up in a criminal underworld after making an error in judgment regarding one of his patients. The thriller premiered in October 2016.