* AlternateCharacterInterpretation: Kohaku probably lends herself to this more than any other character. [[spoiler:How much control does she have over SHIKI/Roa's actions? Is she drugging everybody, and how often? Does her backstory excuse her actions? It's made worse by the fact that the answer to any of these questions, and more, could be answered quite differently depending on the route. Makihisa Tohno also lends himself to this, though it's mostly along the lines of whether he's truly a monster or something less, due to much of his villainy being in response to factors beyond his control.]]
* AnticlimaxBoss: [[spoiler:Roa / SHIKI.]] The game made you think that he is a truly BadAss enemy that [[spoiler:even Arcueid knows isn't an easy opponent]] or [[spoiler:made Akiha increase her powers in order to destroy him]]. When we have the Shiki vs. BigBad fight, what happens? [[spoiler: Shiki kills him with very little effort]]. I know that Shiki's eyes are the killing weapons, but still...
** Justified in Hisui's route since[[spoiler: SHIKI was undergoing a VillainousBreakdown from killing his blood sister Akiha and had been severely weakened in his earlier fight with her. After the death of his only close relative by his own hands, its possible that at that point SHIKI was hoping to die.]]
* CrackPairing: Some side stories and doujinshi suggest Nero/Kohaku make a good couple. His Melty Blood VictoryQuote against her hints that [[spoiler:Kohaku is [[TooSpicyForYogSothoth so tragic a figure his beasts instinctively refuse to eat her]].]]
* CrazyAwesome: When Shiki snaps, he snaps awesomely, and in ways that put [[GetterRobo Ryoma Nagare]] to shame.
* CrowningMusicOfAwesome: Say what you like about it [[MemeticMutation not existing]], but the one thing the ''Shingetsutan Tsukihime'' anime got absolutely PERFECT was Toshiyuki Omori's opening theme, [[http://www.youtube.com/watch?v=wVNM4ksQyv8 'The Sacred Moon']]. One of the most outright ''beautiful'' anime openings ever made.
** 'Justice' (the song playing in the background during the Shiki/SHIKI fight in the anime) is not half-bad either.
* EnsembleDarkHorse: Nrvnqsr "Nero" Chaos and Satsuki "Sacchin" Yumizuka seem to be well liked, with the former due to his badassness and the later for her cuteness and unfortunate fate both in-game and metawise.
* FanNickname: "The Tohno Gland" (Shiki's ability to attract women no matter what he does - fans joke it's pheromones).
** It would be more correct to say "Nanaya gland" though since he is biologically a Nanaya. However, since it's just a joke it doesn't really matter.
* FunnyAneurysmMoment: Once you go through Hisui's route [[spoiler:and learn the truth about Kohaku ''everything'' involving her]] becomes very, very cringe inducing.
* HoYay: Even noticed in-story: Neither Shiki nor Arihiko use {{Honorifics}} when talking to each other, but it's Shiki's habit of also referring to Arihiko by his [[FirstNameBasis first name]] (a habit usually attributed to girls) that makes Akiha do a double take.
** Some Les Yay with Kohaku and Akiha was only made worse(or rather, better) in the anime. Kohaku's back being turned means the scene with [[spoiler:Akiha sucking Kohaku's blood]] [[DoesThisRemindYouOfAnything looks a]] ''[[DoesThisRemindYouOfAnything helluva lot]]'' [[DoesThisRemindYouOfAnything more questionable]].
*** ...that's pretty much impossible, since the game's CG rather clearly shows [[spoiler: Akiha sucking on one of Kohaku's naked breasts]]. It was actually less explicit in the anime.
*** That CG also shows specifically that [[spoiler:Akiha is sucking Kohaku's ''blood''. The anime being less explicit means it looks more like she's suckling]].
* ItWasHisSled: Most newcomers to the series know all of the spoilers that are supposed to be surprising twists, because of the amount of side-stories and sequels written for the game. [[spoiler:1. That Shiki is really the adopted son of the Tohno family. 2. That SHIKI exists. 3. That Kohaku and Hisui switched roles and Kohaku is actually a StepfordSmiler.]]
* MemeticMutation: ''Many.'' It comes with [[{{Memes/Nasuverse}} the territory]].
* MoeMoe: When she isn't [[spoiler: [[PersonOfMassDestruction ripping people apart]] with [[UnstoppableRage maniacal glee]]]], Arcueid is frankly the sweetest and cutest "girl next door" you'd ever have the good fortune of meeting.
** Taking her on a date, though... that'd be tough. And you actually have to do that at some point in the game. HilarityEnsues.
** Akiha also fits this trope like a glove.
* MoralEventHorizon: Makihisa Tohno seems to embody this in just about everything he does, despite being a PosthumousCharacter.
* NightmareFuel: So, so much Nightmare fuel. [[spoiler: Help me. Help me. helpmehelpmehelpmehelpmehelpmehelpmehelp me. I should just become a doll.]]
** All routes have insanity creeping into Shiki's head at some point, but the entire middle part of [[spoiler:Hisui's route sees the protagonist immobile, in bed, gibbering unintelligibly as he descends into several different kinds of madness ''simultaneously''. You're playing a game from the perspective of a character who is desperately, vainly trying to cling onto the tattered wreckage of his personality; afraid to be awake for fear of what he'll do to the people around him; terrified of going to sleep because of the murderous dreams that invade his mind; all the while tormented by agonizing migraines and uncontrollable bouts of furious rage...]]
*** And the ''very worst'' part of this is when, locked in the throes of madness, you see [[spoiler:Kohaku's [[UncannyValley true smile]]]] for the first time.
*** [[spoiler: which isnt helped by Kohaku masquerading as [[EmotionlessGirl Hisui]] at the time.]]
** Shiki going into TranquilFury mode is either this or [[CrowningMomentOfAwesome completely fucking awesome.]]
** The manga, by virtue of being illustrated, shows off much better why Shiki's Mystic Eyes nearly drove him insane at first. Having the entire hospital, and especially all the people in it, covered with the lines makes them look both incredibly fragile and freaky as all hell.
** Also from the manga, we get a depiction of what happened to Ciel after she revived from being killed by Arcueid wile possessed by Roa. Bascially, the Church attempting to 'correct' as what they saw as an unnatural body, had her killed at least ''six hundred times'' including such deaths as by drowning, burning and organ removal, the whole time as she begged them to stop, only quitting when they decided she'd be more useful as a Burial agent. Afterwards, Ciel is shown as completely broken and resigned.
* OffscreenMomentOfAwesome: Neko Arc and Satsuki in the Plus Disc cheerfully hint at the details of the Satsuki route climax. It involves [[spoiler:a MeleeATrois with Shiki, Arcueid, Nero, semi vampiric Satsuki and Roa.]] And something about a magic cannon, but they refuse to [[{{spoiler}} elaborate]] since [[RunningGag Satsuki will be getting her route any day now, right?]]
** To be fair, Neco-Arc was probably embellishing a little bit or outright lying - especially on the cannon. But Satsuki does seem to be listed among the heroines in the EnhancedRemake coming out, so the truth might soon be there...
* OneTrueThreesome: Shiki/Arcueid/Ciel and Shiki/Hisui/Kohaku are the most common. Also Shiki/Akiha/[[VideoGame/MeltyBlood Melty Blood]]'s Sion.
* PlayerPunch: Arcueid's route. [[spoiler: Roa cuts Arcueid in half. The player's response, if they're remotely human, is "'''BURN!!! MAIM!!! KILL!!! ROA MUST FUCKING DIE!!!'''"]]
** [[spoiler: And Shiki is oh so fucking happy to provide. Shiki snaps like a twig in a hurricane. The rest? [[CrowningMomentOfAwesome Is history.]]]]
** Happens in Hisui's route ''twice'' within about a 20-minute span. [[spoiler:[[NiceJobBreakingItHero Shiki calls out to Akiha]], who was winning the fight against SHIKI with Kohaku's help, distracting her long enough for SHIKI to go for a fatal blow on Kohaku, only for Akiha to step in, take the blow, and die instead. And if that weren't bad enough, [[FromBadToWorse Kohaku kills herself not too long afterward, her mission of revenge on the Tohno completed with the death of Akiha.]]]]
* {{Squick}}: In order to hone and maintain the Psychic Abilities within the family, the Nanayas practiced a heavy system of inbreeding which resulted in severely deformed individuals
* TheWoobie: Oh where to start? There's all 5 main heroines to start with. Then there's Len, Sacchin, and Nanako. But above all of those is [[spoiler: the real Tohno SHIKI. Not Roa, SHIKI. Just think about his life for a second, you'll see it.]]
** Becoming the monster he is now can be blamed on at least three things beyond his control, [[spoiler: a combination of his particularly strong awakening of the Tohno's demon blood, being the 18th reincarnation of Roa, AND being locked in a basement for years while Kohaku drugged him and generally fucked with his mind]]. He didn't really have much of a chance.
*** The side-story game ''Kagetsu Tohya'' gives a small amount of closure to this with the final, hidden TearJerker bonus story "Drinking, Dreaming Moon" where [[spoiler: Shiki and SHIKI finally meet on friendly terms in a [[OrWasItADream dream]].]]
** Shiki has had more than a few traumatic experiences in his backstory too. Getting kicked out of his home by his father for having a near lethal injury that made him see death everywhere is only the beginning, and that's not even getting into the more spoilerrific elements of his backstory. Though to give an example of one of those bits, [[spoiler: the opening scene, before the hospital? ''That's his entire blood related family being slaughtered right before his eyes.'']] He's remarkably well adjusted in spite of it.