- The "Freak Show" level alone qualifies. It features several different types of enemies, all of which represent some kind of Body Horror. This includes flies and maggots with human faces, twin brothers attached at the waist (that wear demented grins and give off a Goofy-esque "hilk-hilk" laugh when shot to death), and severely tortured sadomasochistic inmates whose eyes have been clamped open and their faces set in terrible rictus grins.
- That's not counting the set pieces. Highlights include...
- The rotting corpse of a "bearded woman" (which is infested with the aforementioned human-faced maggots).
- A "fly trap" chamber whose floor collapses to reveal a soup of rotting flesh beneath.
- Chamber of Horrors, showcasing the worst of the Medieval era. Seriously, who would include a torture chamber in a freak show?!
- Also disturbing is the industrial food processing plant beneath the Chamber of Horrors. One of the inmates is sent stumbling into a grinder, and you get to watch as the bloody goo from it and other corpses gets poured into gigantic bowls on a conveyor belt. You later see similar bowls inside the gigantic playpen that you stumble into, where it becomes clear what the whole point of that macabre process was: making food for Junior...
- That's not counting the set pieces. Highlights include...
- The horrific boss fight with Junior, a gigantic infantile Frankenstein's Monster that chases you around a huge playpen/arena, complete with giant toys, while a very eerie version of "Pop Goes the Weasel" plays. The only way to finish it off turns out to be having to shoot it so that it stumbles back into the crib-like "lightning bed" that revived it—the electrical discharge turns Junior into a huge lump of charcoal, and the head rolls off. It's so disturbing, Midway included an option to replace Junior with a somewhat less disturbing boss—a huge and demonic teddy bear monster, appropriately-named Deaddy.
- The rides in Rickety Town are dangerous. The "Slay Ride" roller coaster is unfinished, so it's definitely true to its name. One of the seats in the "Dino-Rama" tilt-a-whirl flies right off the platform, and in the "Garage", the bumper car crashes into the wall, sending the players right through. And in case no one has noticed, none of the rides have any seatbelts or safety harnesses. In short? Adult Fear at its finest.
- When Evil Marie is defeated, she gets impaled on the spire of a fountain. Her blood is seen flowing into the water, turning it red as the screen fades to black. Especially worth noting, as this is the only boss not counting Tökkentäkker himself to feature the camera showing different shots of the death to maximize its horror.
- Even the mooks that aren't straight-up zombies, like the Flap-Jack acrobats and the gas station attendants, remain drop-dead horrifying—they keep on flashing those frozen, goofy grins even after you've blown half their heads off and severed their limbs. You can even shoot their bodies down to the bone or blast them to pieces.
- Umlaut spouting gory rhymes before each level, while more subtle than everything else on this list, doesn't help.
- When he does these rhymes, he is shown floating in front of a black background with a purple spinning spiral. Which raises the question of where he is in relation to the player when he does this. Some people speculate that he is causing the player character to hallucinate.
- Look at the lighting in these scenes. For the scenes before the first three levels, it alternates every few seconds between a yellow and a purple glow on Umlaut's face, which are the colors of his jester costume. But before the Big Top level, it just flashes red. That's how you know you're really in for it with this level.
- The music that plays during these scenes is a simple, happy little circus tune. Soundtrack Dissonance at its finest.
- On a similar note, the music coming from "Big Bunyan Ride." While it's a catchy song, it reaffirms that this carnival has so much animosity for you that it will take any opportunity to express its desire to see you killed.
- One of the power-ups you can find is an acid bath. When you shoot enemies with it, they flail around in agony as they slowly melt into sludge. And all the while, the acid bubbles and hisses...
- Another one is the flamethrower, which allows you to burn foes. Though terrifying for some, you'll find it pleasurable if you're obsessed with fire.
- The Haunted House level in its entirety.
- Special mention goes to the kitchen, which is easily one of—if not the—most disturbing section in the manor. You'll notice the human carcasses being butchered by the zombies...and then you might remember that the protagonist and Betty were part of a tour group in the prologue. Whatever happened to them, hmm?
- Enemies pop out of secret passageways and holes in the walls, often without warning.
- Once the player gets up on the roof and glances over the edge, a passing car knocks them off the roof and into an open grave with a headstone reading, "Rest in Pieces".
- In a nice nod to supernatural slasher films, you get chased through the Haunted House by Hambone. He's a huge burned man in overalls, wearing a hockey mask, and has a gatling gun for a hand. Hambone appears to chase you after crashing one of the attraction's cars, charging in after you while on fire. There is literally no way to shoot him down before he mauls the players, with him unloading a storm of bullets in your direction. Even when he goes down, he'll attack again when you get further with a new gun that fires exploding skulls.
- When the player enters the Big Top tent, the first thing they see is the ticket booth, which reads, "Pay with your LIFE!"
- The center ring in the Big Top opens to reveal what looks like an operating room, and it becomes clear that Tökkentäkker plans to put your brain in the body of the "Ape" — a gorilla with chain gun arms — which was featured on the poster that you may have seen upon entering. How, you ask? By sending a wave of demonic clown surgeons to saw your skull open!
- The ending of the game. The heroes manage to beat Tökkentäkker and send CarnEvil back to the underworld, just barely surviving a fall from an exploding Zeppelin. They wake up, its daytime and they're back in front of Tökkentäkker's grave. There's a sudden clatter, and a new token is dispensed. Our hero picks it up, obviously considering it for a moment...and then, despite Betty's pleas, he promptly inserts it into the Umlaut statue's mouth! The game ends on Umlaut's eyes opening as the screen darkens, his evil laughter rising above Betty's scream of terror.
Nightmare Fuel / CarnEvil