- Casey Becker's death. She's so close to being saved, and then her parents close the door unwittingly. It's not a quick death, and to make matters worse, her parents are frantically searching for her even as she's being stabbed and gutted. The music in the background (by Beltrami) is heart-breaking and desperate both at once, even more-so by how she manages to see the face of her killer just before she dies. You can almost imagine her still being warm as they find her.
- Even worse, Casey's mother picks up the phone and hears her being stabbed to death.
- Randy's death. It was a pity one of the franchise's most beloved characters was mutilated beyond belief. As an extension, his video will in Scream 3 for some fans. Especially the end.
- Derek's death, and his last words
Derek: I'd never hurt you Sidney.
- Maureen being killed in plain sight by who she believes is her boyfriend. Even worse since the audience didn't even know it was actually real until she straight up drops dead. Her acting may be a little over-the-top, but it's still pretty sad once you give this scene some thought.
- Kate Robert's final words, "Tell Jill I'm... so sorry." What really drives it home is that since this was all Jill's fault, killing her mother was part of the plan.
- The backstory of Brandon James, a killer that terrorized the town years before, born disfigured, his mother homeschooled him, and his father was ashamed of him. When he went out in public he wore a mask, and has a crush on a girl named Daisy. He approached Daisy had took his mask off in front of her, causing her to scream and several jocks to "rescue" her and beat up Brandon. After a killing spree and manhunt, Brandon was shot by police when he met up with Daisy again, who was in on the sting operation. Also Daisy was Emma's mother.
- Audrey's Not So Stoic breakdown after Rachael's death. So far it's the only time in the series that Audrey hasn't been an unshakable Deadpan Snarker. It's very clear she really loved Rachael and is determined to put her killer to justice.
- Riley's death. Not only does Riley die just as her relationship with Noah is taking off and before he can get intimate with her, but Noah watches via Face Time as Riley bleeds to death. Her last words are especially heartbreaking:
Riley: I can....see our stars.
- This continues from episode 3 and through a good chunk of episode 4, where we see how genuinely affected most of the characters are by Riley's death, showcasing how liked she was by everybody and what a bright spot she was to them in their lives, thus making her death be one of the biggest Tear Jerkers of the whole franchise.
- The Chirpster poll on which of the Lakewood Girl Posse should die next. Brooke has over 300 votes. Love her or hate her, Brooke's total shut down is a jarring change from her vapid facade of the previous episodes.
- Even worse when you realize things like this sometimes happen in Real Life.