Annie Stewart, the oldest child born to David and Ellen Stewart, had a very happy childhood. Surrounded by people who loved her, she never wanted for anything. She was a bright, happy child who never gave her parents any trouble. That is until she turned 16. At 16, Annie suddenly developed an attitude and starting running around with wild guys. Annie openly defied her mother and sneaked around with a college man. However, Annie's bravado almost got her in trouble when her date decided to "get lost" in the woods and seduce her. Luckily, Annie was able to outsmart her seducer and call her father for help.

That incident scared Annie into growing up and she quickly matured into a sweet confident young woman. While in college, Annie was introduced to Beau Spencer, a friend of her sister, Dee. Beau, whom Annie disliked since she felt he was cocky and self-centered, immediately began putting the moves on Annie, but knowing that Dee had a crush on him, Annie resisted his advances. Despite the fact that Beau's charms were wearing on her, Annie was determined to stay out of Beau's way and she shared her fears with her good friend Tom Hughes. Tom had an idea: If he told Beau that Tom and Annie were dating, maybe Beau would leave her alone. Unfortunately, the plan didn't work, and one night Beau kissed Annie. When Beau promised her they'd just be friends, Annie hoped he meant it, but confessed to Tom that if it weren't for Dee, she might be pursuing Beau, too. When Beau figured out that Annie and Tom were just friends, he launched an all-out effort to win her.

Meanwhile, ever since Beau kissed her, Annie realized that she had deep feelings for Beau. Knowing how much Dee cared for him, and unwilling to hurt her little sister, Annie decided to transfer to another college, even though Beau told her the only reason he was hanging around Dee was so he could be near Annie. Finally, Beau gave Annie an ultimatum: either she tell Dee about her feelings for him, or he would. Soon after, Annie was caught in a mining accident and was left in a coma for a short time. In March 1977, when Annie regained consciousness, she confided in Tom that although she loved Beau deeply, she couldn't be with him because of Dee. Beau tried to convince Annie that denying their love was wrong, but Annie said she would rather hurt herself than hurt her younger sister, and she didn't think they should see each other anymore. However, Dee proved equally selfless and freed Beau and Annie to pursue a relationship, and in May 1977, the two became engaged.

A thorn in their happiness, however, was Beau's mother, Jane Spencer. Jane liked to control her son's life and definitely didn't like having Annie for a daughter-in-law. Jane objected to Beau's aspirations of becoming a lawyer and suggested that he should run the family hotel in order to support his wife. Meanwhile, Beau and Annie constantly fought about money and his ability to become a lawyer. At the same time, Jane manipulated Beau and told him that she would sell the family hotel if he quit. The stress of the situation caused Annie to quit school in order to support her husband. After quitting, she was shocked to discover that Beau had been having an affair with Melinda Grey! Betrayed, Annie immediately divorced Beau.

After Annie finally divorced Beau, in the Spring of 1979, she moved out of her parents' home, and moved into an apartment that she shared with a young fashion design student, Barbara Ryan. While living with Barbara, Annie's new friend, hospital resident Jeff Ward, persuaded Annie to go on dates and an attraction started to develop. However, Jeff would soon find competition from a much older source. The new Memorial hospital administrator, Doug Campbell, liked Annie, too, and although she was very attracted to him, since he was a married man and Annie didn't want to get involved. Ultimately, Doug decided to give his marriage another chance. By the summer of 1979, Jeff wanted to take their relationship a step further and become lovers, but Annie's thoughts kept going back to Doug. At the same time, Dough's wife, Marcia, began to suspect there was another woman and decided that If Doug could play around, so could she! She turned to Jeff, but he didn't respond since he had his eye on becoming chief of surgery and didn't want a scandal on his hands. When Doug turned him down, Jeff was sure it was because of Marcia and Annie. Driving home from the hospital one night, Doug told Annie he was going to file for divorce. Getting out of the car, Annie unknowingly dropped a scarf with her initials on it. Marcia found it and put two and two together. It didn't help that she'd seen Doug and Annie kissing. Marcia warned Doug that if he asked for a divorce, she would ruin Annie's reputation. Meanwhile, Jeff got the chief of surgery position. Later, when he refused to testify for Marcia against Annie and Doug, Marcia was livid! She went to Ellen and told her that her daughter was having an affair with a married man. That was it for Doug, and he packed his bags. Marcia tried to stop him from leaving, but she'd had too much to drink and fell down a flight of stairs. Marcia was rushed into surgery where Jeff saved her life. Immediately after, Doug left town for parts unknown.

Annie then became involved with land surveyor, Brad Hollister. Annie fell deeply in love with Brad, they soon married and Annie became pregnant. Unfortunately, Annie lost the baby when she learned that Brad was in love with Dee. Realizing her marriage was a sham, she left Brad and gave Dee permission to date him.

In the spring of 1982, after Annie finally passed her medical exams and began her residency at Memorial, Jeff arranged for her to work with him. The pair grew close again, and Annie finally told Jeff that she loved him. When Jeff told his friend, Karen Haines, she became hysterical and was admitted to the hospital with no memory of their conversation. Jeff and Annie tried to talk to her, but Karen freaked out and verbally attacked Annie. David was angry at Jeff for leading Karen on, and Annie was upset by her father's devotion to Cynthia Haines's daughter. One day, when Jeff sent Annie a note about a date, Karen intercepted it and changed the time. She then snuck out, for hospital room and went to Jeff's apartment. Annie arrived and found Karen in a towel. Later, when Jeff couldn't understand why Annie was mad at him, Annie finally figured out what Karen was doing and set a trap. Karen found a love note from Jeff to Annie and the message read, "You're caught." With Karen defeated, Jeff found himself free to propose to Annie, and she said yes, on one condition: After having had two miscarriages, she wanted to find out first whether she could carry a baby to term. In the meantime, although Karen pretended to be happy (or at least satiated), she was furious and made it clear to Jeff that she never gave up something she wanted.

One day, in June 1982 shortly before Annie and Jeff were to marry, Karen snuck into the lab at Memorial and found the tests confirming that Annie could bear children, and altered them. Annie was devastated and Jeff disappointed, but he declared that he wanted to marry her anyway. They were about to get married when Annie started to feel queasy. She was pregnant! Jeff was ecstatic, but Annie's joy was tempered by the fear of losing the baby. David wondered about Annie's test, and after the wedding he rechecked the tests and realized someone had tampered with it. He told Cynthia he suspected it was Karen, and Cynthia advised Karen to tell the truth or leave town. Eventually, Karen admitted that she was responsible. Soon after, Annie learned that she was pregnant with twins! Later, in the fall of 1982, Annie and Jeff would learn something more startling; she was actually pregnant with quadruplets. Annie gave birth to the children on February 8, 1983, two boys and two girls. Annie received a call from President Ronald Reagan congratulating her on the birth. Thrilled, they named their youngest daughter Nancy, after Stewart family friend Nancy Hughes and first lady, Nancy Reagan. They named their other children, Maria (after Jeff's mother), Lowell (after Ellen's maiden name) and Gregory (after Jeff had found out his biological father's name, was Gregory).

While Annie was still pregnant, Jeff was already feeling the pressure of both a hectic work schedule and raising a new family. At the time Annie and Jeff discovered that she was going to give birth to quadruplets, Jeff decided to try Dexedrine, an amphetamine, as a way to deal with his stressful schedule. Soon, Jeff became addicted to Dexedrine and started becoming confused in his work. During the New Year's Eve celebration at the Stewarts, Jeff continued his downward spiral by taking a downer. Finally, after the quads were born, Annie questioned Jeff about some amphetamines she found, and Jeff finally had to admit to having taken them. Then one of the quads developed symptoms of Reye's syndrome, and David confirmed the diagnosis. When the baby became more ill, Jeff was the only doctor available to do the surgery. He could get through it only by taking a pill. Jeff gradually sank into a morass of drug abuse, complete with street pushers and a near-fatal car accident, where he almost had a head-on collision with another car. Finally, in November 1983, Jeff finally hit rock bottom in a seedy motel, where he went through withdrawal. Annie and the Stewarts were deeply concerned and when Jeff came home, the next morning, they asked him where he'd been. At first, Jeff got verbally abusive to Annie and her parents, but then he finally broke down and told them all that he needed help. At the end of 1983, Jeff checked himself, with the support of Annie, Ellen and David, into a drug treatment center. By the quads' 1st birthday, Jeff had gotten help for his drug problem. Soon after, Annie was offered a lucrative job in Denver from hospital administrator, Kent Bradford, and she and Jeff left Oakdale with their children.

Annie and Jeff and the quads did return to Oakdale twice. Once, in April 1986, for Nancy and Chris Hughes's 50th wedding anniversary, where she and Dee gave advice to Betsy about Steve Andropolous, and in July of that year for Chris's funeral, where Annie and Dee gave Emily advice about James Stenbeck.