The first change from the story to the film is renaming Jig as Ash. Ash has little or no symbolic meaning, while Jig was used by Hemingway to convey one of the parts of the plot, "the jig is up, and the charade is over." In the beginning of the story, Jig believes that the man loves her and trusts that he will be with her. Near the end, however, she no longer believes he loves her and has decided to give up on him. Thus, "the Jig is up." By changing her name, this aspect of the plot is not conveyed as well by the film as it was originally by Hemingway.

The screenwriters also changed Jig's age. The actress playing Jig appears to be in her early 30's, while in the story Jig is a "girl." Hemingway made Jig a girl in the story to make her inferior because she is a girl and her friend is a man. By making her a woman, the film takes away the inferiority meant to be conveyed by Hemingway.

Another change made by the screenwriters was to the scenery. In the story, the couple never leaves the train station. In the film, they were arguing at the station about getting the abortion, and then they cross the train tracks and walk through an olive grove. This change of setting breaks the tension and claustrophobia of the story, which makes reading the story more exciting. By going to the olive grove, the film eliminates important dialogue and adds meaningless background information instead. The tension that arises when the couple is confined to the table in the train station is a more effective way to tell the story than walking through the olive grove.

Finally, the screenwriters rearranged critical dialogue. One of the first statements Jig makes in the film, is to say, "I feel fine. There's nothing wrong with me. I feel fine." In the book, on the other hand, this statement is one of the last pieces of dialogue. In the book, it is important because of its placement. By the time Jig says she is fine, she has had an epiphany and indicates it by her statement. She feels fine because she has figured out that the man does indeed not love her. By making this the first line said by Jig, the screenwriters eliminated her important epiphany from the film.

Hills Like White Elephants has symbolism throughout the whole story, whereas in the film, the characters explain what the symbolism and metaphors mean. One instance in the film is when Jig says, "the hills look like white elephants," and the man replies, "what is a white elephant I've never seen one," to which Jig says, "white elephants do not exist they are just something you don't want," thus explaining the symbolism behind the quote and the film's title. Providing an explanation in this manner detracts from the film watcher's need to interpret and discover the story's meanings on his/her own, which is ultimately less effective because it makes the film watcher less involved.

After reading the story by Hemingway and watching the film, it is immediately evident that they are very different. The film switches the dialogue often and also adds new setting and names. Considering Ernest Hemingway was dead long before the film was produced, he had no input and his ideas were not correctly represented. Much of his intended symbolism was left out of the film and certain feelings of anxiety and tension amongst the couple were ruined. The short story by Ernest Hemingway was far more effective at conveying these feelings than the film.