- Ass Pull: The ending where Quilla is abruptly killed off-screen and eaten by Blood at literally the last minute really seems to come out of nowhere, and resolves the plot in a gruesome way that comes entirely out of left-field.
- Crosses the Line Twice: The movie turns the ending (in which Vic and Blood eat Quilla) into this, capping it off with the title song (an upbeat country tune) and the main duo laughing about it.
Blood: Well, I'd say she certainly had marvelous judgement, Albert, if not... particularly good taste. (laughs uncontrollably)
- Cult Classic: The movie has grown into this in recent years, even becoming more iconic than the novel for some people. It also helps that it went on to inspire Fallout.
- Harsher in Hindsight: In 1977, a couple of years after the film adaptation was released, a mentally unstable man named David Berkowitz (also known as the "Son of Sam") murdered several people, allegedly under the orders of a dog that could speak to him. Sounds awfully familiar, doesn't it?
- The protagonist's name is Vic, and he has a dog. More than 30 years later, football player Michael Vick was arrested and charged for his involvement in an illegal dog fighting ring.
- Mood Whiplash: The movie has a pretty solid and consistent tone/premise...for the first hour. After Vic enters Topeka, it undergoes a Genre Shift, and turns into a bizarre combination of The Twilight Zone and 1984. There's also the Sudden Downer Ending.
- Squick: The "milking" scene.
- What Do You Mean, It's Not for Kids?: Based on the fact that the title is the archetypal A Boy and His X formation, more than one parent or grandparent has taken a child to see this movie. If there is any scene in this film that's appropriate for minors, it's very short.