The full plot of The Sum of All Fears runs in three stages: the bomb changes hands, it detonates in Baltimore, and Ryan talks two governments back from the brink. Spoilers follow.
First, Dressler's network takes the bomb from the arms trafficker who bought it. Second, Ryan follows clues that it has reached the United States, but he cannot stop it being shipped to Baltimore. Third, it explodes at a football game, destroying much of the city and fatally wounding Cabot.
The fallout is political before it is military. A Russian general attacks a US aircraft carrier, and President Fowler, believing Russia is to blame, orders a retaliatory strike. Ryan is the one person pulling the other way. He works out from the bomb's isotopes that the material came from the US rather than from Russia, which undercuts the assumption driving both governments toward war. Meanwhile, CIA operative John Clark finds the dying arms dealer Ghazi in Syria, and the agency then hacks the dealer's computer, which points to Dressler.
With that evidence, Ryan reaches Nemerov, who agrees to stand down, and Fowler does the same, so the war is avoided. The people behind the plot are killed. Fowler and Nemerov then announce new steps against weapons proliferation. In the final beat, Ryan's adviser Anatoli Grushkov turns out to be the informant known as Spinnaker, and he gives Ryan's fiancée Catherine an engagement gift.