Lexie was adopted by her parents as a baby and didn't even realize she was adopted. Her aunt Frankie had always been in her life. Lexie came to Salem with high aspirations, and fell in love with Police Head Honcho Abraham Carver. They wed in April of 1989, and after spending some time in Chicago, came back to Salem. In the early nineties, Lexie began to have feelings for her husband's brother Jonah. Jonah started "cleaning up" the streets of Salem, all because Lexie had made a simple comment about how unsafe the streets were. When Lexie learned that Jonah was the Pacifier, she ended up being kicked off the police force for helping him. Although they were willing to reinstate her, by that time, Lexie had decided to give medical school a try. She fought her feelings for Jonah for a long time, and eventually things smoothed over in her marriage. Jonah moved on with Wendy, his girlfriend, and Lexie became settled into married life.

Lexie, with Abe, followed the rest of Salem to Aremid, a mysterious city where Stefano owned a house. She found out that she was adopted and went on a chase to find out who her real parents were. The resident village weirdo, The "Parrot Man," dropped random hints about her ancestry. Lexie was sure that Frankie/Celeste knew who her real parents were. Celeste lead her on a wild goose chase for as long as she could, even telling Lexie that her deceased parents lay dead in an Aremid cemetery. When Lexie went to the gravestones and read the dates, it said "her parents" had died a good one hundred years before she was born. Lexie continued to search for more clues. Finally, The Birdman gave in and revealed that Celeste was, in fact, Lexie's birth mother, but refused to name the father. The Birdman finally said Stefano was her father. She found out that Celeste had given birth to Stefano DiMera's child after they had become involved. Not wanting " the DiMera Curse" to control her daughter, she gave her up to the loving parents Lexie grew up knowing, who just happened to be Celeste's sister and her husband.

Abe and Lexie went back to trying to have children, a dream they had been working on for years. For awhile, Lexie even thought she was pregnant, but it turned out not to be. Having lost her job as a police officer over the vigilante issue, Lexie had turned to medicine, and was a resident at University Hospital. She was slowly getting closer to both of her parents, but when Vivian needed to convince Stefano that she was dying, Lexie initially went along with it, until her conscience started to eat away at her. Abe and Lexie finally gave up on having children of their own, and decided to adopt. Stefano talked them into adopting the child of Rolf's niece Margo, but he had a plan of his own...he switched Margo's baby with Hope's baby at birth, and the child that Abe and Lexie named Isaac and took home with them was in reality the Brady baby. For months Lexie and Abe were in blissful ignorance. They had the baby they had always wanted, and he was a beautiful, healthy baby.

Lexie eventually realized the truth, but by then, she couldn't bear the thought of giving up the little boy she had been raising. When Abe would not help her, she left Salem with the boy, and it was during that time that Abe relinquished custody to Hope and Bo. Once Lexie was returned to Salem, she was forced to return the child, and left with no baby, as Margo's former lover Glen had come to town and reclaimed the child Bo and Hope had been raising. Lexie was prohibited to have any contact with the little boy who thought of her as a mother, but she couldn't stop herself from going to his christening, where she knew Rolf was going to try something. At the same time, it seemed her marriage to Abe was over forever, and Lexie had a one-night stand with Brandon Walker. She was finally able to accept that she lost Isaac (now known as Zack) when she learned she was pregnant. The only problem? She didn't know who the father was!

Throughout her pregnancy, Lexie never told Abe that Brandon was a possible father, and Abe was overjoyed to find out that he was about to be a father at his age. After a fairly easy pregnancy, Lexie prepared to give birth to a baby whose father's identity was still up in the air...on-air paternity tests had said Abe was the father, but Sami had switched the results. Only hours after giving birth to her son, Lexie was confronted in the hospital by an angry Brandon Walker and his scheming new wife, Sami. Brandon demanded to know if the child was truly his. Lexie shocked everyone there by saying that she planted the test result that said Brandon was the father, knowing she could use it to prove Sami was lying and manipulating, and that actually, the baby had belonged to Abe all along. Brandon was saddened to lose a possible child, but thrilled to learn that he had a little half-brother (this was the same day that Brandon revealed he was Abe's son from a long-standing affair with Fay Walker).

With their son Theo in their arms, Abe and Lexie felt their family was finally complete. They made preparations for little Theo's christening. Lexie waited at the Church for Abe, but tragically, he was never to get there. Abe was shot on the pathway in front of his home by the Salem Stalker, and despite the best attempts of the staff at Salem University Hospital, Abe died only hours after being found, leaving Lexie and Theo to go on alone. Although devastated, Lexie was soon thrown into the lives of her friends and family as the Salem Stalker began killing others in town. It was Lexie who was the one to comfort Jennifer when Jack was killed only weeks after Abe, and Lexie who had to be the one to tell Mickey Horton that his beloved Maggie had passed away. She was also the one who had to give Jennifer Deveraux the devastating news that it looked like the baby she was carrying would be born with serious defects.

While grieving for Abe, Lexie began to open her heart up to ISA officer turned cop Tek Kramer, who had been there for her constantly since Abe died. She was finally beginning to move on when the shocking news came that the dead might not be dead after all. Not only was Lexie horrified that Abe might be alive and she was moving on with her own, but the thought that she had miss-pronounced the deaths of her friends and family (Tony was one of the stalker victims) was one that stayed with her no matter how she tried to forget it. When it was proven that they were all alive and well, Lexie was thrilled to have Abe back with her and Theo, although she felt slightly guilty about the feelings she had been developing for Tek. Her happiness was almost short-lived after learning Abe was having serious vision problems. When her step-son (and former lover) Brandon Walker came back to town, Lexie was determined to stop him from getting involved with Sami Brady again. Although she tried, nothing she did worked. Brandon was still just as in love with Sami as ever, but determined not to interfere in her new happiness with Lucas.

After Brandon left town, Lexie focused on her marriage to Abe, but Abe's blindness and impotence was causing problems between them. Abe was having trouble adjusting to his new life, and he and Lexie fought a lot, Lexie often reduced to tears. Tek was there for Lexie when she needed a shoulder to cry on, and the two ended up having sex in her office. Lexie soon regretted her act, especially when Abe told her he wanted to work on their marriage, but Dr. Alex North knew she had slept with Tek, and when Lexie threatened to reveal his hypnotizing Marlena, Alex blackmailed her, stating that if she said anything to anyone he would divulge her affair. After Alex revealed himself as the husband Marlena had once thought dead long ago, he apologized for what he had done, and when Marlena chose to stay with Alex, the matter was dropped on both sides.

Lexie's attempt to move on with her life and her life with Abe ended abruptly when her former lover, Tek, witnessed E.J. shooting John Black in a warehouse. She and Tek were forced to fake their deaths in order to save their own lives. However, Andre kidnapped Lexie before she could leave Salem. Months later, Lexie was discovered in a series of tunnels beneath Salem. She attacked both Bo and Hope before being subdued, and quickly joined the Bradys in their plots to bring down André before reuniting with Abe.

In February 2008 Lexie became chief of staff at Salem Hospital. Her work began to take a toll on her marriage and she and Abe entered marriage counseling. They soon learned that work wasn't their problem, but the fact that their son Theo was having developmental problems. He wouldn't speak and couldn't relate to other kids. In the summer of 2008, Theo was diagnoses with autism.

In order to spend more time with her son, Lexie resigned as Chief of Staff, but remained at the hospital as a doctor. She also supported her husband, Abe's campaign for mayor. In November 2008, Lexie became Salem's First Lady.

Despite Abe's positive career turn, Lexie continued to struggle with her relationship with her son and her father. Lexie grieved the death of her "brother", Tony. After his death, she tried to embrace Stefano and E.J., despite their criminal behavior.

Lexie managed to successfully keep a truce between her family and husband, until the fall of 2011 when E.J. announced that he would be running against Abe for mayor. Lexie was furious with E.J. Despite steering clear of personal attacks, Abe lost the election. As a peace offering to Lexie, E.J. offered her the job as public health commissioner. But, Lexie soon had other health and family topics to worry about.

In spring 2012, Lexie learned that she had a long-lost brother. Celeste had another child who had been kept from her and the family for years. Lexie and Cameron were thrilled to meet, and Cameron quickly formed a bond with Lexie and her family. But they did not have much time to spend together as Lexie was diagnosed with an inoperable brain tumor.

After some research, Abe learned that the brain tumor could have been caused by extended exposure to fumes like those present in the underground tunnels where Andre kept Lexie prisoner. Even though Stefano didn't personally lock Lexie in the tunnels, he knew that Andre was dangerous and thus felt a great responsibility for Lexie's tumor. Lexie forgave Stefano and made peace with him. When Stefano was fatally shot a few weeks later, Lexie helped plan his memorial service.

Lexie opted not to go forward with any treatment, but to spend her remaining time doing things that she likes with people that she loves. Abe and E.J. recreated France in the town square so that Lexie could have her day in "Paris." Friends came to the Carver house to share memories with Lexie. Lexie made scrapbooks and videos for Theo and Abe to watch after she died. And, she also left instructions for all of her friends to watch out for Theo and Abe.

As Lexie grew weaker, she spent more and more time at home. Finally, Lexie died in Abe's arms while the two of them sat together in their garden. A few days later, friends and family gathered to say goodbye to Lexie in a memorial service that consisted of dancing, poetry, and laughter.