Unmarked spoilers ahead. You've been warned.
- One of the very first images is of the sole survivor of a brutal massacre brought on by this film's very own Art the Clown, leaving her with a horribly disfigured face. It gets worse when you find out why she looks like that. Art was eating her face while she was still alive. Oh yeah, and she not Art gets the first onscreen kill, brutally attacking a TV show host and gouging out her eyes.
- Art the Clown in general. He's a 6'2" Faux Affably Evil Monster Clown with rotting teeth and black and white face paint, and revels in some of the most horrific carnage put to screen in recent years. Unlike most slashers, he absolutely loves taking his time with his kills, especially when he's killing or torturing women. He also silently mimics maniacal laughter whenever he claims a victim. From an interview with Damien Leone on his previous effort featuring Art:Even if he pulls out a kitchen knife, you'll never see him simply stab someone in the stomach and walk away. He's gonna use that knife in the most hideous manner.
- At the end, Art shoots himself to avoid being arrested, and his body is taken to the morgue. But then, once the coroner unzips his body bag, the lights flicker and Creepy Child voices can be heard ... and then Art very much alive and well grabs the coroner by the neck and presumably chokes him to death. So yeah, Art's now got supernatural aid.
- Dawn's death scene. She's strung upside-down and completely sawn in half from the crotch down to the top of her head. We also get a glance at her intestines falling out as Art slowly hacks away at her.
- The crazy woman goes looking for her "baby," (actually a doll that she calls "Emily") and encounters Art cradling "her" in a narrow, filthy hallway. While this isn't that scary of an image by itself, having your baby abducted by an Ax-Crazy clown certainly falls under Adult Fear.
- Art prancing around wearing a woman's scalp and her skinned chest. Turns out they belonged to the aforementioned crazy woman, who he just left bleeding out without allowing her the dignity of death.
- The gritty, truly menacing soundtrack done by Paul Wiley deserves special mention. A mix of synth drones, repeating patterns, and dark ambience in the vein of John Carpenter, specifically his Halloween soundtracks.