Dr. Urbino Daza's lunch with Florentino to Florentino and Fermina's journey aboard the riverboat

Dr. Urbino Daza asks Florentino to lunch, during which he thanks Florentino for the companionship he provides for Fermina. Ofelia, however, thinks that love in old age is ludicrous, and insists that Florentino discontinue his visits. After Ofelia is so adamant that Fermina demands she leave the house, never to return. After his lunch with Dr. Urbino Daza, Florentino falls and twists his ankle. Ordered by his physician to remain in bed for sixty days, Florentino is terrified by the possibility that he may die before he is well, without seeing Fermina. Again, Florentino and Fermina correspond regularly in letters, and Fermina quickly realizes how much she misses him.

Shortly thereafter, the city's gossip magazine, Justice, publishes a front-page story which announces, falsely, that there had been a secret love affair between Dr. Urbino and Lucretia. Mortified, Lucrecia dares not contact Fermina, which Fermina interprets as an admission of guilt. The tabloid also attacks Lorenzo Daza for counterfeiting money. Both articles cause Fermina terrible anguish. A letter in her defense is published in the city's newspaper, which Fermina knows is from Florentino because he uses a recognizable pseudonym. Meanwhile, América, who suffers terribly from her loss of Florentino's love, finds copies of his love letters to Fermina.

When he is well, Florentino invites Fermina to travel with him on a pleasure cruise along the river. She accepts, and feels immense relief at the prospect of leaving home with only her bare necessities. She and Florentino board the ship, the New Fidelity, after bidding farewell to Dr. Urbino Daza and his wife, who had not known that Florentino was to accompany Fermina on the trip. The Doctor hesitates, but recovers with a cordial goodbye after Florentino shows him the keys to his and Fermina's separate rooms.

Initially, Fermina feels lonesome and wants only to cry in solitude. Florentino gives her peace, and interrupts her only to say good night. She suggests that they retreat to her private deck, where he rolls cigarettes for her to smoke. Florentino notices that Fermina is crying silently, but instead of consoling her, as she hopes he will, he panics and asks if she would prefer to be alone. She assures him that his presence is welcome, and he reaches for her hand, which he finds waiting for him. When, upon his departure, he motions to kiss her, she withdraws; "not now," she tells him, "I smell like an old woman." After Florentino departs, Dr. Urbino appears to Fermina, and tips his hat in farewell.

Florentino divulges how he has longed for her for over half a century, and lies that he writes verses only for her. Upon hearing this, she reaches for his hand and allows him to kiss her cheek, then her lips, when he departs. Florentino shudders, for Fermina truly does smell like an old woman, though he feels immense happiness. Later, Florentino receives a telegram from Leona that informs him of América's suicide; he erases the news from his mind, but cries for América later on.