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5[[quoteright:350:https://static.tvtropes.org/pmwiki/pub/images/shub_niggurath.png]]
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7This is ''South Park'' after all, so this game isn't without any morbid content.
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9'''Moments pages are Administrivia/SpoilersOff. Administrivia/YouHaveBeenWarned.'''
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11* The teaser from the Ubisoft press conference has the sinister image of the Lincoln memorial being disfigured and his face replaced with a skull. It's actually more terrifying and evocative than most apocalyptic film imagery.
12* Captain Diabetes runs out of insulin and dies from a diabetic coma during the first night. Hearing him desperately calling out for his mother and suffering a DisneyDeath is very hard to watch, especially if you're a diabetic yourself.
13** Later on, during the battle with Red Wine Drunk Randy during the same night, he starts with an attack on Captain Diabetes that the game shows will OneHitKill them. Letting the move connect will have Randy deal Captain Diabetes an attack that one hit kills him ''[[TheresNoKillLikeOverkill over and over again]]'' in a long and drawn out NoHoldsBarredBeatdown that can be rather hard to watch, not helped by Classi, who's watching and commentating over the battle, actively rooting for Randy to beat the ever living daylights out of him.
14* The underground section of the police station. There's an in-house morgue filled with corpses of past victims, a forensics lab with a cutscene of the scientist suffocating to death on toxic fumes [[note]]You don't actually see him die because the lights are shut off, but you do get to look at his dead body when the lights cut back on.[[/note]], and a chamber where Outer God Shub-Niggurath feeds upon black citizens that were wrongfully arrested by Park County's police so that they can be sacrificed to her.
15* The day after Coon and Friends agree to merge with Freedom pals, the New Kid is treated to a trail of blood starting from outside their parents' bedroom and ending in the kitchen, where it climaxes into a horror show of blood smeared on every surface. Then when the New Kid goes to Freedom Pals' headquarters, the team is given a video message revealing that Mitch Conner ([[CoughSnarkCough *cough!* Eric Cartman *cough!*]]) has kidnapped the New Kid's parents and is threatening to "make them disappear" if the New Kid doesn't do exactly what he asks. When the New Kid is done doing favours for Mitch Conner, [[ILied he tells them that no, he won't set their parents free]].
16* Dr. Mephesto's lab quickly goes ''Film/JurassicPark'', but because a lot of the subjects are human it's exponentially creepier - to the point where Clyde has an emotional breakdown. And if you talk to the other kids, you'll find out that they're just as rattled too.
17** Turns out the Sixth Grader Leader was being restrained inside a little glass cubicle where visitors can pay twenty five cents to affix extra butts onto him. Problem is that he's completely aware of what's going on, what Dr. Mephesto is doing to him, and how much pain he's in. The Sixth Graders may be annoying jerks, but they're still children who aren't even that much older than the main cast.
18* In Chapter 4, in order to get the DNA to proceed, you need to kill one of your parents to harvest their DNA. [[SadisticChoice There is no third option.]] Either outcome ''will'' result in you killing one of your own parents, and both results are awful.
19* Three words: Mutant Cousin Kyle. He's the end product of taking an ordinary young boy and warping him into a titanic, pulsating flesh tumour. [[NightmareRetardant Granted, the Nightmare Fuel gets watered down by the fact he still has the same dorky personality and voice,]] but it doesn't do a whole lot. Then it becomes [[FridgeHorror horrifying all over again]] when you remember that Cartman did this to one of his own classmate's family members for the sake of his stupid agenda.
20* The BadFuture where Mitch Conner succeeds in making every day Christmas. South Park is already a CrapsackWorld to begin with and Mitch just made things worse: the adults are too high on cat urine to care about anything besides getting wasted, picking fights, and ransacking everything, almost every building in town has been closed and shuttered, the local abortion clinic has a waiting line of third trimester pregnancies going out the front door, and Woodland Critters are running around killing for fun. [[WhatTheHellHero Cartman really thought turning his hometown into a holly jolly hellhole]] [[PyrrhicVictory was an acceptable sacrifice for a chance to make more money than Freedom Pals.]]
21* The Woodland Critters themselves. They're [[KillerRabbit adorable little animals, with cutesy voices and chipper personalities...]] who worship {{Satan}}. They slaughter people left and right, just because they can, [[FauxAffablyEvil without ever dropping their sweet personas]]. And they're introduced in the game when one of them uses his Satanic powers to [[YourHeadASplode blast Mr. Mackey's head into paste]] right in front of a bunch of nine year old kids.
22* It's a little thing and nothing ever comes of it, but after you finish Mosquito's companion quest, the Raisins Girls make a post on Coonstagram telling Clyde that [[ParanoiaFuel they know where he lives and they're coming to beat him up]]. And to prove their point, they doxx him by publicly posting his street address.
23* During the scene where Super Craig was trapped by and then "wounded" from being splashed with lava Lego bricks, The Coon steps in to revive Super Craig...and ''[[WorstAid stabs Craig's chest with an actual intracardiac injection]]''. This shocks Craig to the point where he breaks character and angrily yells at Cartman for almost killing him.[[note]]To clarify, percutaneous intracardiac injection risks include coronary artery lacerations (puncturing the heart's blood supply), pneumothorax (collapsed lung), and hemorrhages within the pericardium (blood filling up the protective sac surrounding the heart, which can make it stop beating altogether). There's a reason why medical professionals don't like to do them anymore.[[/note]]
24* A subtle example, but have you noticed how every time you approach Clyde's house you might see the front door close, yet when you go inside, nobody's home? Just as a reminder, Clyde's mom was killed after he didn't put the toilet seat down, and her ghost was spotted at the end of the same episode.
25* The DLC Bring The Crunch as a whole, given it’s a parody of slasher flicks.
26** Especially bad in one of the side quests that involves taking selfies with ghosts. You take a selfie with this ghost in the middle of camp, then instead of a selfie, you suddenly get a jumpscare from an EvilDoll. Definitely can be a shock when you first encounter it.
27* Cartman's journal is one parts funny and one parts unsettling. It's filled with drawings of his friends (and Sheila Broflovski) either having sex with each other or getting murdered. It's one of those moments that paints him less as an over-the-top PoliticallyIncorrectVillain and more like a [[TroublingUnchildlikeBehavior deeply disturbed child]].
28* Sober Towlie starts off fine when he's talking to you about how great his life has been after getting clean, but as the conversation rolls on he slowly spirals into becoming angrier and angrier until he finally loses it, kicking off his fight sequence with [[https://i.ytimg.com/vi/UYDyPx1vOnA/maxresdefault.jpg some pretty alarming - but cool - splash art.]]

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