"Black Jack: Child from the Sky" is a two-episode anime OVA based on Osamu Tezuka's iconic manga series, "Black Jack." The story centers on Dr. Black Jack, an unlicensed but highly skilled surgeon, who encounters a mysterious child named Pinoko. The narrative begins with Black Jack discovering Pinoko in a remote mountain village, where she is being worshipped as a deity due to her unusual origins. Pinoko, a child with a unique condition, was created from the cells of a teratoma tumor removed from a young woman named Akemi. Black Jack, recognizing her humanity, takes her under his care and performs a life-saving surgery to stabilize her fragile existence.

The plot explores the ethical and emotional complexities surrounding Pinoko's creation and her place in the world. As Black Jack navigates the challenges of caring for her, the story delves into themes of identity, humanity, and the moral dilemmas of medical science. Pinoko's childlike innocence and unwavering devotion to Black Jack contrast with the darker undertones of her origins, creating a poignant dynamic between the two characters. The narrative also touches on societal perceptions of those who are different, as Pinoko faces prejudice and misunderstanding from others.

Throughout the OVA, Black Jack's surgical expertise and unorthodox methods are showcased, reinforcing his reputation as a maverick in the medical field. The story balances moments of tension and drama with heartfelt interactions between Black Jack and Pinoko, highlighting their evolving bond. The OVA serves as an origin story for Pinoko, providing insight into her character and her relationship with Black Jack, which becomes a central element in the broader "Black Jack" series. The narrative concludes with Pinoko firmly established as Black Jack's companion, setting the stage for their future adventures together.