Horror’s a big category with lots of unique and worthwhile subsets like: vampires, romantic vampires, campy vampires, well-dressed vampires, teenage vampires, and possibly others too. Extreme Horror is one notable sub-genre and a relatively new phenomenon. It can be seen as the new millennium’s return to horror’s grisly roots after the largely sanitized post-modern efforts of the 90’s (like Scream and all its tongue-in-cheek copycats). With precursors like The Texas Chainsaw Massacre (1974), Cannibal Holocaust, and the notorious Guinea Pig paving the way, the below twisted tales are standing on the shoulders of some rather fucked up giants. They all transcend the simple “torture porn” moniker and offer up some genuine meat to go with the all the gristle. If you’re looking for some of the darkest, mind-warping Extreme Horror movies then look no further:

5. High Tension a.k.a. Haute Tension (2003) Dir: Alexandre Aja

High Tension was one of the first examples of the then-burgeoning New French Extremity movement and bludgeoned unsuspecting audiences with its blend of traditional thrills and depraved violence. The movie follows the strong friendship between Alexia (Maïwenn) and Marie (Cécile De France) as they eventually have to evade an unstoppable killer in a typical rural locale. The relatively straightforward slasher plot is pushed to the extreme by inventive and shocking gore (a severed head gives head), proving Alexandre Aja as a major talent to watch. The controversial ending is either brilliant or brilliantly idiotic depending on your point of view, but it’s sure to inspire a reaction.

Further Viewing: The Hills Have Eyes (2006) Dir: Alexandra Aja

Aja rode a wave of blood and success from High Tension to his North American debut, the remake of Wes Craven’s The Hills Have Eyes. Featuring some heavy-handed symbolism amidst a sun-dappled desert setting, Aja’s remake has intensity to spare. It’s also an anti-American screed directed by a Frenchman, adding a wonderful layer of subversiveness. The centerpiece of the film is the white-knuckle assault on a family RV by a pack of cannibalistic mutants; I still recall people leaving my theatre in droves during this scene. Good times.

4. Three… Extremes (2004) Dirs: Fruit Chan, Takashi Miike, Chan-wook Park

Three… Extremes is an anthology film featuring three of Asia’s best genre directors each contributing a segment. Master of revenge Park Chan-wook directs Cut, a self-referential tale involving a film director forced to make some devastating decisions. The prolific Takashi Miike contributes Box, an eerie and evocative story about the divide between dreams and reality. But it’s Dumplings by director Fruit Chan that’s worth the price of admission. Later turned into a full-length feature, it details the efforts of Mei and her magical dumplings that ward off aging. Of course, the dumplings are made with some rather unusual  biological materials that have to be smuggled from a local hospital. I’m not about to spoil what the secret ingredient is, but it’s incredibly squicky, stomach-churning and totally tasteless. Accomplishing a great deal through suggestion and excellent sound design (like Hitchcock), Dumplings will ensure that you won’t be eating the titular food any time soon.

Further Viewing: Ichi the Killer (2001) Dir: Takashi Miike

To say Takashi Miike is a prolific director is an understatement. He’s got 95 directing credits on IMDB in the 24 years since he started making movies, but they’re not all great so you have to separate the wheat from the chaff. An extreme film in every sense of the word and a true standout is his Ichi the Killer. Mind-bogglingly violent and drenched in every bodily fluid imaginable, Ichi is a Yakuza film in theory but a gonzo exploration of psycho-sexual violence in practice. Alternately goofy and horrifically gory, it contains images you’ll never forget no matter how hard you try.

3. Hostel (2005) Dir: Eli Roth

Eli Roth’s output doesn’t get the attention it once did but it’s hard to overstate the shock that greeted Hostel when first released. The term “torture porn” was created seemingly overnight to describe this film by hand-wringing and morally superior masses of outraged Middle America. Revisiting it, Hostel does stand on its own as both a condemnation and confirmation of America’s xenophobia and as a pure showcase for realistic torture sequences. The first half is all goofy frat bros partying it up in Europe (and is genuinely funny), making the abrupt switch to pure horror in the second half all the more jarring. This is another film that I fondly remember walkouts happening in the theatre, and I still get sweaty palms thinking about that drill in the goddamn leg and everything that happened after. I think Roth’s detractors would like to paint him as lightweight and shallow, but it’s exactly that deftness that allows him to play with genres and make his actual horror all the more surprising and disturbing.

Further Viewing: Hostel: Part 2 (2007) & The Green Inferno (2013)

Roth’s follow-up Hostel: Part 2 was unfairly ignored upon release, despite the fact that it took the typical plot of women in peril and empowered them in a story that is actually about weak men trying (and failing) to hold onto their power. More bloody and disturbing than its predecessor, it upped the ante in every way while retaining a message that’s arguably more potent. Also, The Green Inferno should have been released by now but Roth’s unfortunately had trouble with his distributer. Directly inspired by Cannibal Holocaust it maintains the odd balance between humour and extreme violence, and features what may be the single most violent death I’ve ever seen on screen. In typical Roth fashion it happens to the nicest guy in the movie. Gleefully sadistic.

2. The Woman (2011) Dir: Lucky McKee

I had the rare experience of seeing The Woman in the theatre as everyone in attendance collectively held their breath from the second reel to the insane finish. Lucky McKee cut his teeth on the disturbing May but brings all his tricks to bear in the utterly insane The Woman. Even describing the plot – which involves an outwardly normal family man (Sean Bridgers) who imprisons and tries to tame a feral woman (Pollyanna McIntosh) in his tool shed – makes me uncomfortable to this day. This is another movie that balances tricky tones of levity and truly mind-melting horror with the requisite buckets of blood. The way The Woman escalates from moderate suburban tale to its audacious and wild finale is both incredible and so intense as to nearly make you sick. An avowed feminist with a penchant for button-pushing, McKee has created a one-of-a-kind movie that is so raw and primal it’s hard to watch at times.

Further Viewing: The Loved Ones (2011) Dir: Sean Byrne

Another movie about forced confinement, Australian writer-director Sean Byrne’s The Loved Ones is a stylish and twisted tale about unrequited love that takes place on that most magical of evenings, Prom Night. Unrepentantly dark yet able to keep the torture scenes novel (another drill! Used here for a home lobotomy), The Loved Ones is worth it alone for the juxtaposition of heavy violence with a well curated pop soundtrack. The solid acting is a nice bonus too.

1. Martyrs (2008) Dir: Pascal Laugier

Ugh. I’m almost hesitant to list this movie. If you’ve read this far then you’re likely interested in following this thing through and Martyrs is indeed the logical endpoint of extreme horror. Beginning with a young girl escaping from – you guessed it! – forcible confinement, she’s rescued by soon-to-be best friend Anna. Later as adults, the former prisoner Lucie (Mylène Jampanoï) contacts Anna (Morjana Alaoui) to let her know she’s found the perpetrators of the violence against her and has enacted revenge. Anna helps the unstable Lucie clean up the remains, but they’re haunted by a creature that may or may not be real. That’s enough plot for a whole film but is in fact only the first half of this movie, with the second half given up to extended scenes of torture and degradation that would be easier to shrug off if they weren’t so well-realized and affecting. It’s not so much the violence, although there is plenty of it (a flaying scene may make you retch), but it’s more the unknowable motivations for it and the implication that pure evil exists in this world, hiding in plain sight. Martyrs is a product of its time, a mirror held up to difficult socio-political circumstances and a screeching howl against the brutality of modern Western life. A meditation on the transcendence of torture and a possible indictment of the whole damn genre, Martyrs is supremely irresponsible, deeply traumatizing, and absolutely unforgettable. Those damn French. I’ve seen it once and will likely never watch it again, and if you’re smart you’ll do the same.

Further Viewing: None. You’ve traversed the nadir of horror films and lived to tell the tale. Congratulations. Take a shower. Fly a kite. Go live the rest of your life!

(Or, take a load off with the comparatively light Best Zombie Movies.)