After a night of wild partying and missing their train, a group of American college athletes is invited to board another that is going their way. Once on board, members of the team start to go missing, and their would-be saviours claim to have no idea what could have happened to them.
When they discover the truth, it is too late to escape and they must for their lives against their captors to put an end to their ride to hell.
- Attempted Rape: After being knocked unconscious, Alex wakes up Strapped to an Operating Table, with Gregor preparing to rape her. She manages to grab a scalpel from the tray of instruments by the table, and stops him permanently by giving him a Slashed Throat.
- Axe Before Entering: Vlad uses an axe to smash open the locked door to the burning train carriage where Dr. Velislava is trapped.
- An Axe to Grind: An axe gets used at several points through the movie. Sheldon uses it perform a Mercy Kill on Todd. At the end of the movie, Vlad uses it to try and kill Alex, before tossing it aside and deciding to use his bare hands. Alex manages to grab the discarded axe and hit Vlad in the stomach with it.
- Bathtub Bonding: Todd and Alex share a bath while they discuss her loss in the tournament, his plans to go pro, and her decision to quit the team.
- Chain Pain: The conductor is hanged with a chain.
- Chekhov's Skill: Early in the film when Alex is having doubts about her future in wrestling, her boyfriend, who's on the men's team, teaches her a move he calls the "Todd Patterson invincible double leg double hook throw". In the end, she uses this move to take out the last antagonist.
- Conveniently Placed Sharp Thing: When she is being Strapped to an Operating Table, Alex manages to grab a scalpel from the tray of surgical instruments next to her. she uses this to cut her bonds, and then slash Gregor's throat when he attempts to rape her.
- Deadly Road Trip: In Eastern Europe, a group of US college athletes participating in a wrestling championship are separated from the rest of their group and miss their train. Accepting an invitation to board another train, they fall into the hands of a gang of organ thieves.
- Drop the Hammer: The conductor attempts to kill Alex with a sledgehammer. This does not go as well as he might have hoped.
- Excrement Statement: Not content with beating Sheldon to a bloody pulp, Gregor and Vasily then piss on him for no reason other than to be complete bastards.
- Extremely Short Timespan: About three days. The party occurs the first night, the second night is on the train, and and the third night is at the medical facility: putting the events of the climax on the morning of the next day. The brief epilogue (a few minutes) takes place an unspecified time later.
- Eye Scream: Vlad pulls Todd's eye from its socket while he still conscious.
- Flaying Alive: The film opens with this happening to a guy, though unlike the rest of the film's victims, he is mercifully unconscious.
- Groin Attack: Sheldon has has his genitals removed (without anaesthetic) by the organ thieves.
- Hooks and Crooks: After finding Claire going through his desk, the conductor drives a set of ice tongs through her throat.
- If You Kill Him, You Will Be Just Like Him!: Subverted. When the head of the organ harvesters who've killed most of the protagonists is at the mercy of the Final Girl, she tries this.Dr. Velislava: You do this, you are exactly like us.
Alex: Maybe I am. [proceeds to beat Velislava up and then burn her to death]
- Karma Houdini: The soldiers who rape (and presumably kill) Claire escape without punishment, as they are not on the train when Alex sets fire to it.
- Kick Them While They Are Down: Alex escapes from the medical facility with the badly injured Willy. She leaves him lying the forest while she goes to scout possible routes of escape. While she is gone, Vasily finds Willy and proceeds to kick the crap out of him while is too weak to fight back.
- Missed the Bus: After a night of wild partying and missing their train, a group of American college athletes is invited to board another that is going their way. Once on board, members of the team start to go missing, and their would-be saviours claim to have no idea what could have happened to them.
- One-Word Title
- Organ Theft: Travelling aboard a Russian train, a college wrestler and her teammates fall victim to a gang of sadistic thieves harvesting human organs.
- A Party, Also Known as an Orgy: The 'party' that causes the team to miss their train is more like a rave: full of drugs, topless women, and offers of casual sex.
- The Peeping Tom: Instead of searching the train for Todd, Sheldon decides to spy on a hot woman taking a shower via a peephole into the bathroom. It is while he is doing this that he is captured by Gregor and Vasily.
- Railroad Tracks of Doom: At the end of the film, Vlad has been badly wounded and left for dead lying on the railroad tracks by Alex. After she has walked off, his eyes snap open to show that he is Not Quite Dead. However, he then hears the sound of a train approaching at high speed and, unable to move, he can only lie there as the train runs over him.
- The Schlub Pub Seduction Deduction: Dr. Velislava seduces Coach Harris in the dining car and takes him back to his compartment. He only starts to question his luck just before she renders him unconscious. When he wakes up, he is Strapped to an Operating Table and she is harvesting his organs.
- Shower Scene: When the team is supposed to searching the train for Todd, Sheldon instead decides to go and spy on a hot woman taking a shower.
- Slashed Throat: Gregor attempts to rape Alex while she is Strapped to an Operating Table. Alex manages to get hold of a scalpel and uses it to slash his throat.
- Strapped to an Operating Table: Happens multiple times as the victims of the Organ Theft ring wake up to discover themselves strapped to an operating table with a surgeon either about to, or in the process of, removing their organs.
- Thriller on the Express: The eponymous vehicle turns out to be operated by organ snatchers.
- Train Escape: After setting fire to the rest of the train, Alex uncouples the last carriage (with her in it) and it coasts gently to a stop while the burning train speeds away.
- Unwilling Suspension: After being stabbed through the chest, Todd wakes up to find himself hanging from his wrists in on of the train cars.
- Vapor Trail: Alex spreads fuel all through the medical carriages of the eponymous train. When Dr. Velislava tries to talk her out of it, Alex casually drops a lit match into the fuel. Only as it ignites does Dr. Velislava realise she standing directly atop the trail leading into the rest of the train. Cue the Oh, Crap! moment.
- Vehicle Title
- Woman on Fire: When Alex torches the train, Dr. Velislava is standing atop the Vapor Trail and goes up like a Roman candle.