Being a subjective genre, horror, much like its fans, is incredibly varied compared to other genres in film. From solid scares, slow-burning tension or just a general spooky atmosphere, there are a lot of things that can be grouped together under the horror umbrella. But, for those that require something a little more unyielding in their form of escapism, extreme cinema enables directors to unashamedly actualize their unrestrained vision onto screen, no matter how brazen the content may seem to the outside community.

Some, regardless of budget, have produced timeless classics reaffirming the importance of this more extreme approach to cinema, whilst some have missed the mark entirely. With that being said, here are some of our top choices from this varied genre!

Guinea Pig: Mermaid in the Manhole (1988) by Hideshi Hino

Guinea Pig: Mermaid in the Manhole

“An artist finds and rescues a mermaid in a sewer. He takes her home with him and she develops sores all over her body that begin to pustulate and bleed. He uses what oozes from her sores to paint her portrait. When he can no longer handle it anymore he breaks down and dismembers her body.”

A personal favorite of the series, Mermaid in the Manhole is a return to a less comedic tone the series portrayed in He Never Dies; however, it is less visceral than the original two films popularizing the series. Instead, it takes an artistic approach to the series’ formula, a complete palette swap of the deep crimson reds for sickly yet vibrant greens and yellows throughout the majority of its runtime. Although the film can slow to a crawl at points, the film follows a similar tenacity as its predecessors towards its conclusion and is an established staple to classic Japanese extreme cinema.

Midori (1992) by Hiroshi Harada

Midori 1992

“Midori is a young girl who sells flowers until her mother dies, leaving her an orphan. She’s conned by a freak show manager into joining his troupe, but once there she sees a shocking variety of deformed people and is occasionally the victim of their depravity. Midori’s situation changes, however, when a mysterious dwarf with a unique magical act joins the freak show. This dwarf is able to put himself through a bottleneck into a glass jar – and that is not the extent of his powers. Midori falls in love with the dwarf, but his ambitions and jealousy will have further unpleasant consequences…”

Many will think that, as disturbing as anime can get, that none of them can truly be extreme given the medium. However, those who say that have not seen Midori from 1992. A passion project of one man to recreate Suehiro Marou’s Mr. Arashi’s Amazing Freak Show, the film is a graphic portrayal of abuse of a minor at the hands of deformed and sadistic circus freaks. Furthermore, the movie contains acts of animal cruelty that are really hard to stomach. That said, the film itself is oddly compelling and unique in approach – fans of extreme cinema should give this one a chance just to test the depths of extreme content in anime.

Fetus (2008) by Brian Paulin

Fetus 2008

“A man loses both his wife and their new baby in the delivery room. In an attempt to contact his wife on the other side, he turns to the occult, descending into an abyss of torture and insanity.”

Unlike the majority of gore films, Fetus has a solid story, based on loss and grief, that encompasses the more violent scenes rather than just being a gateway from one to the next. Despite the occasional, questionable acting by the film’s lead, the actor gives an impressive performance projecting the character’s sense of hopelessness upon the audience. It thus solidifies his willingness to try to contact the one he loves, no matter how gruesome the cost may be. An underrated addition to the genre, the film deserves more recognition than it has received.

The Untold Story (1993) by Herman Yau & Danny Lee Sau-Yin 

Macau cops begin to suspect a man running a pork buns restaurant of murder, after tracing the origin of a case full of chopped up human remains that washed ashore, which leads them to him.

No list of extreme cinema would be complete without a trip to Hong Kong and their list of Cat III films. Admittedly, there are plenty of titles here that can fit the bill. From the most infamous in Ebola Syndrome to the notoriously nasty with Red to Kill, the genre has no shortage of extreme and controversial horror. However, The Untold Story is just as deserved of being a notable title in the annals of HK Cat III, offering a great performance from Anthony Wong that culminated is one of the most haunting images of self-cancelation you will see anywhere. 

XXX: Dark Web (2019) by Various

XXX: Dark Web 2019

XXX: Dark Web is a 2019 anthology film composed of shorts directed by Domiziano Cristopharo, Adam Ford, Alex Hernández, Emanuele Marchetto, Daniel Valient and Lorenzo Zanoni respectively and produced by Tetro Video. The film is somewhat a spiritual sequel to the 2018 film Deep Web XXX. A young man browses the dark web in search of perverse videos, but gets more than he bargained for.

Bringing together some of the most notable names in modern extreme cinema, the anthology focuses on violence and sexuality in an unflinching manner – certain sequences will be seared into your memory. Furthermore, each creator brings their own flair to the project, and is a perfect entry point into current talent pushing boundaries in underground cinema. Make no mistake, XXX: Dark Web is easily the most challenging on this list that few will be able to stomach, but the challenge is worth taking – how far down the rabbit hole of extreme cinema will you go?

Red Room (1999) by Daisuke Yamanouchi

Red Room 1999

“How low would you go to win a million dollars? Just how desperate are you for the cash? Desperate enough to enter the Red Room? In this latest and most vicious game show to emerge from the Japanese underground, four contestants (a husband and wife on the edge of divorce, and two sisters) are locked in the Red Room to draw cards in the “king game.” Whoever draws the king selects two others to enter a cage where one performs the most outrageous acts upon his or her unlucky victim. The game is played to the death. Survivor takes all, and the losers go home in body bags!”

Director Daisuke Yamanouchi may not be a name too many fans of extreme cinema are overly familiar with, although he did receive considerable notoriety from his film Girl Hell 1999 being listed in the proverbial extreme cinema iceberg that has been floating about. However, the man is one of the best purveyors of nastiness from Japan, relying on a twisted dark humor to elevate his films beyond mere misery porn. As such, Red Room is the perfect starting point: a repulsive death game that pins a small group of people against each other, devising new means to torture and eliminate their competition. The film even has a sequel that amplifies the stakes and violence.

Blind Beast (1969) by Yasuzo Masumura

Aki modelling for Machio

“A blind sculptor kidnaps an artists’ model and imprisons her in his warehouse studio – a shadowland of perverse monuments to the female form. Here a deranged passion play of sensual and sexual obsession is acted out in world where sight is replaced by touch.”

Trawling along extreme subject matters, Blind Beast is one of the least graphic entries to be included in this list. That notwithstanding, the production is a brutal exploration of abduction, sadomasochism and self-destructive love, beautifully framed in its own surreal world with an artistic sensibility. Incorporating stunning cinematography as well as an effective use of sound, this pushes the film forward into something that transcends extreme cinema. In short, Blind Beast is an incredibly evocative movie from one of the pioneers behind Japanese new-wave cinema.

The Sadness (2021) by Robert Jabazz

The Sadness 2021

“The city of Taipei suddenly erupts into bloody chaos as ordinary people are compulsively driven to enact the most cruel and ghastly things they can imagine. Murder, torture, and mutilation are only the beginning… A young couple is pushed to the limits of sanity as they try to reunite amid the violence and depravity. The age of civility and order is no more.”

The Sadness burst onto the festival scene and immediately made a mark on the circuit. Arguably, the film is the most polished and chaotic extreme horror production ever created. As the film becomes more readily available and makes its way among the horror fanbase, it will be one of those films people talk about for years to come when discussing the most extreme cinema.

Irreversible (2002) by Gaspar Noe

Irreversible 2002

“Events over the course of one traumatic night in Paris unfold in reverse-chronological order as the beautiful Alex is brutally raped and beaten by a stranger in the underpass, and subsequently seeks revenge upon her assailant. A simultaneously beautiful and terrible examination of the destructive nature of cause and effect, and how time destroys everything.”

The usual formula for r*pe-revenge films is flipped in this production by playing in reverse chronological order, displaying these acts for what they truly are: a series of brutal, depraved and traumatic experiences. The raw presentation elicits a blunt impact from these scenes, removing any cathartic sensibilities or reasoning to effectively craft a more disturbing result. An incredible piece of cinema, this film deserves its place on top film lists and is a must watch for cinephiles, if only once.

Hotel Inferno (2013) by Giulio De Santi

“The contract killer Frank Zimosa has just been hired for a ridiculously lucrative mission by the rich and powerful Jorge Mistrandia. The objective: to kill a couple of people hiding in one of his European hotels. What would look like one of the simplest jobs Frank has ever had is just about to turn into a living nightmare.”

Giulio De Santi has been making these wonderful over-the-top gore films since his debut solo effort Taeter City, and any of his productions, past or future, are worth the experience. However, Hotel Inferno (and its subsequent sequels) are wonderful examples of excess from a first-person perspective. Featuring remarkable practical effects, Frank Zimosa goes through hell ruthlessly, killing numerous cultists and weird demons. The film delivers a relentless barrage of excessive and perverse gore that will please those who love the ‘red kroovy’ to flow in excess.

Man Bites Dog (1992) by Rémy Belvaux, André Bonzel and Benoît Poelvoorde

Man Bites Dog 1992

“The activities of rampaging, indiscriminate serial killer Ben are recorded by a willingly complicit documentary team, who eventually become his accomplices and active participants. Ben provides casual commentary on the nature of his work and arbitrary musings on topics of interest to him, such as music or the conditions of low-income housing, and even goes so far as to introduce the documentary crew to his family. But their reckless indulgences soon get the better of them.”

A poignant look at the depravity of man, the film is styled as a faux documentary based around the extremely charismatic serial killer Benoit. Man Bites Dog blurs the line between everyday life and scenes of extreme violence, portraying conversation ranging from philosophy to poetry and the correct way (ever so morbidly) to dispose of a corpse. With this, the crew slowly succumbed to a disturbing state of desensitized and compliance in these vile acts which included abduction, r*pe, and murder. The intimate approach, conversing directly with the killer, still feels shocking decades after the film’s release.

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