Ballet is typically thought of as a pleasant dance form — the Dainty Little Ballet Dancers are graceful and elegant, the plots tend to be romantic, historical, or fantastic stories set to a sweeping stage design and bombastic music, and the impressive tutus are pretty. However, there is an unnerving element to it. Not only do ballet dancers have to rely on raw acting and athletic ability to tell the story, they also have to contort themselves into exceedingly difficult positions in order to sell the choreography, and often do so in synchronization.
Things are usually worse offstage. The physical training required to achieve such grace and flexibility is grueling, and may be paired with the struggle to maintain the ideal slender body for ballet. The mental pressure on the dancers doesn't help and neither do clashes with other dancers, the Prima Donna Director, the choreographer, or anybody else involved in production. In addition, many classic ballets draw on fairy tales and gothic romance tropes or have otherwise violent stories, making it easy to twist these stories into something darker.
Some works run with these notions and use the intensity of ballet to highlight horrific or unsettling things. Maybe the heightened form of drama ballet brings and the high-stress environment surrounding it takes a toll on a ballerina's sanity, the physical requirements results in mutilation (especially Agony of the Feet), the Dream Ballet takes a scary or dramatic turn, or the art itself is directly tied to the supernatural. In particular, the ethereal visage of a graceful ballerina might be tied to something ghostly. Overall, there is a lot of storytelling mileage in the dichotomy between the feminine, delicate-looking performance and its darker underbelly. See Subverted Innocence.
- In Speed Grapher there was a ballerino nicknamed 'The Rubber Gimp' who became so obsessed with being flexible. He became so unhinged, that he broke a little girl's arm for 'being too stiff'.
- Evoked in Hunter × Hunter with one of Neferpitou's Nen abilities, Terpsichora, a monstrous ballerina-like figure that appears to have them on strings. Pitou commands it to make her "dance past [their] limits", resulting in freakishly strong leaps.
- In Avengers: Age of Ultron, one of the flashbacks to Black Widow's Dark and Troubled Past as a Russian spy/assassin is a brief, intense ballet scene during her training, where the instructor demands that they become "unbreakable".
- Black Swan: Ballerina Nina begins to lose her mind when she is cast as the roles of the White and Black Swans in her company's staging of Swan Lake, since the pressure from her mother, director, and rivals don't let up. She starts to become self-destructive both physically and mentally, and begins to hallucinate an evil doppelganger.
- The Cabin in the Woods: The "Sugarplum Fairy" looks like a Dainty Little Ballet Dancer from behind...before she turns around and reveals a face comprised of nothing but a Lamprey Mouth.
- Compared to the book, the film of Crooked House presents the topic of ballet more prominently. Close to the end, Lady Edith has a disturbing dream of Josephine dancing ballet around their house among rays of bright light. She eventually figures out that Josephine is the murderess, and later Josephine's own diary reveals that she killed her grandfather because he refused to pay for her ballet lessons. When Lady Edith decides to Mercy Kill Josephine after that to spare her a life in a mental institution, she promises the girl she's taking her to study ballet at last.
- Evil Dead 2: Linda's decapitated corpse moves like a creepy ballerina. The body pirouettes, the head stays still.
- The French supernatural horror film Livid. The villain is a ballet teacher who is also a vampire, and she and her daughter would feed on her students. Ballerina ghost mooks also feature at one point.
- The Red Shoes (1948) is set at a 1940s ballet company, where a story similar to the fairy tale The Red Shoes is being staged. The Show Within a Show's heroine is danced to death by her cursed pair of red slippers, while the film's heroine is torn by love and drama and eventually kills herself, seemingly under the shoes' influence.
- Suspiria (1977): The ballet institute the heroine starts at turns out to be a front for a coven of witches.
- In the climax of Us, it is revealed that Adelaide's doppelganger was able to copy her performance of the Dance of the Sugar Plum Fairy when they were children, and their deadly fight is intercut with flashbacks to the ballet.
- The "Waiting in the Wings" episode of Angel, where a ballerina is cursed to repeat the same performance for her jealous Romantic Runner-Up. After 110 years, the Fang Gang is able to break the curse and set her free.
- In the Buffy the Vampire Slayer episode "Once More with Feeling", Dawn has to escape the musical-inducing demon through a contemporary ballet sequence.
- Doctor Who In "Asylum of the Daleks", Amy hallucinates a group of strangers pirouetting... before the illusion breaks and they are revealed to be murderous Daleks.
- Elementary: The murder in the episode "Corpse de Ballet" (a pun on corps de ballet) is a ballerina being split in half during rehearsal.
- On The Gong Show one act was entitled "Zombie Ballet". The dancers wore zombie makeup and danced to Profokiev's "Dance of the Knights".
- Supernatural: In the episode "Out With the Old", a ballerina finds a cursed pair of shoes that causes her to dance herself to death.
- The ballet Giselle is about spurned women who turn into ghostly spirits who dance men to the death.
- In Fate/EXTRA CCC, Meltryllis performs dances based on those from operas like Giselle. She uses those dances to rip her foes to ribbons with her Armed Legs and melt them into data for her to absorb and devour.
- Five Nights at Freddy's: Sister Location has the animatronic ballerina Ballora. She, along with the other Funtime animatronics, tries to kill the protagonist a few times throughout the game. To add to the horror, she gets her own Ominous Music Box Tune and an eerie song she sings.
- Widowmaker from Overwatch was a ballerina before she was brainwashed into becoming the villains' most effective assassin. Although she's a stoic killer now, she still references her ballet background in her ballet emote and her "Odette" and "Odile" skins themed after Swan Lake. However, Widowmaker does not use her ballet to unnerve her enemies, but rather it is presented as one of the last manifestations of Amelia LaCroix's former life that still exists inside her scrambled mind.
- In the Screaming Author case of Spirit Hunter: NG, attention is drawn to a ballet performance of "Duck Lake" that one of the victims was slated to star in. It's eventually revealed that said girl was kidnapped and mutilated to resemble a crane, much like how the princess in the play is forcibly transformed into a bird.