- 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 anything seen in most apocalyptic films.
- Captain Diabetes runs out of insulin and goes into a diabetic shock. Hearing him desperately calling out for his mother and suffering a Disney Death is very hard to watch, especially if you're a diabetic and even moreso if you had suffered the same thing.
- The underground section of the Police Station. There is a morgue filled with the remains of the officers' past victims (which are, thankfully, covered in wraps), and while the cutscene that plays when entering the Forensics Room can invoke a bit of giggles, the officer's corpse that appears after he turns the light on can be a bit startling. And to top it all off, there is a chamber where the harrowing Outer God Shub-Niggurath lurks, and its revealed that the officers are subduing black citizens so that they can be fed alive to her!
- After the Coon and Friends agree to assimilate with the Freedom Pals, the New Kid can wake up in the morning to find their parents are missing and their kitchen drenched in blood! What follows is just as bad if not worse! When the New Kid goes to Freedom Pals headquarters, the whole team is given a video message revealing Mitch Conner (*cough!* Eric Cartman *cough*) has kidnapped the New Kid's parents and threatens to make them disappear if the New Kid doesn't do exactly what he asks from them. New Kid is even shown to be visibly worried for their parents' safety. The whole situation was horrifying enough that our heroes spend a several moments trying their best to reassure the New Kid that they'll find their parents while the New Kid's forced to let Mitch Conner play them like a fiddle, as if the New Kid's friends believe that behind their stoic demeanor, the New Kid must be scared and worried out of their mind, and they're likely right!
- Dr. Mephesto's lab quickly goes Jurassic Park, but due to the subjects being human, it comes off much more horrifying - to the point that Clyde starts having an emotional breakdown.
- In Chapter 4, in order to get the DNA to proceed, you need to kill one of your parents to harvest DNA from. There's no third option. Either outcome will result in you killing one of your own parents, and each result is horrifying.
- Three words: Mutant Cousin Kyle. The horribly grotesque appearance of something that used to be a regular young boy, twisted into a gigantic mass of flesh, to which the European Spanish dub adds a demonic reverb. Granted the nightmare fuel is lessened a bit by the fact that he still has the same dorky personality and Jewish voice, but that doesn't help to lessen the twisted appearance. It becomes a lot more horrifying when you realize that Cartman knowingly mutated one of his own classmate's family members in order to further their twisted agenda. This specific classmate also happens to be his Arch-Enemy, but nonetheless is a whole new level of fucked up.
- The Bad Future where Mitch Conner succeeds in making every day Christmas. South Park is already a Crapsack World to begin with, and Mitch just made things worse; the adults are too addicted to and high on cat urine to care what is happening, and the Woodland Critters are killing people left and right.
- The Woodland Critters themselves. They're adorable little animals, with high-pitched, cute voices and chipper personalities... who worship Satan (complete with imagery), their preferred method of attack is to incinerate the party with hellfire, and start out as a Hopeless Boss Fight. They slaughter people left and right, essentially just because they can, without ever once losing their "cute" personas. Oh yeah, and they're introduced to the player when one of them uses their Satanic powers to blast Mr. Mackey's head into chunks right in front of a bunch of nine year old kids.
- Nothing comes of it, but after you finish Mosquito's companion quest, the Raisins Girls make a post on Coonstagram letting Clyde know that they know where he lives and that they're coming to beat him up. They even post his address on Coonstagram to prove their point. Even the normally dense Clyde gets unnerved by the latter.
- During the scene where it had looked that Super Craig was wounded due to being splashed by the lava Lego bricks during a rescue attempt, The Coon steps in to revive Super Craig...and 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. When the rest of the boys go off in pursuit of Professor Chaos, Craig is giving Cartman the scariest, angriest-looking "I'm gonna kill you" face South Park has ever shown.
- A subtle example, but you notice every time you enter a certain street and approach Clyde's house, you see the door closing, yet when you go inside, nobody's home? Just as a reminder, Clyde is the one whose mom was killed when he didn't put the toilet seat down, and her ghost was even seen by the end of the same episode. These small details raise a few eerie questions...
- The DLC Bring The Crunch as a whole, given its a parody of slasher flicks.
- Especially bad in one of the sidequests 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 Evil Doll. Definitely can be a shock when you first encounter it.
Nightmare Fuel / South Park: The Fractured but Whole