First of all, I’m gonna throw down the NSFW gauntlet for these 13 most disturbing movies of the last 13 years because what you are about to witness is, as the name suggests, a list of not exactly your grandma’s horror movies. These are the most twisted, most gnarly, most graphic horror films ever. Their intent is to scar you. Their purpose, to become your nightmare. In the patheon of twisted, these reign supreme. The sample pictures I’ve included alone should be enough to scare you off from ever watching any of these twisted entries in a troubled genre. Treat this as a dare, not a suggestion. You enter the territory of the twisted on your own accord. If you’re still around by the second to last entry, may God have mercy on your soul.

When you get down to it, there are really only three kinds of horror movies. One revels in the viscus; the excrement, blood, and guts. Evil Dead (2013), Ichi the Killer (2001), Hostel (2005), Saw (2004), Wolf Creek (2005), The Human Centipede (2009), Cabin Fever (2002), or House of 1000 Corpses (2003) all fit the category. They’re bloody. They’re gory. They make you cringe and hide your eyes. They peddle in shocking you, they thrive on your disgust.

Another breed of horror plays psychological mind games, keeping you on your toes and daring you to predict the twisted turns they’ll take next. They seep into your subconscious. They welcome you to tear your hair out. Shutter Island (2010) is one such example. The Conjuring (2013) is another. The Orphanage (2007), Borgman (2014), Paranormal Activity (2007), The Sacrament (2013), Pontypool (2008), Pan’s Labyrinth (2006), The Last Exorcism (2010), May (2002), The Ring (2002), Let The Right One In (2008), Honeymoon (2014) and The House of the Devil (2009) are others. They don’t necessary douse you in blood but their impact, though muted, is often even more sustaining.

The third is more campy, more goofy but usually equally, or even more, gross. Take the following examples of modern campfests: Drag Me To Hell (2009), Death Proof (2007), You’re Next (2013), Slither (2006), Fright Night (2011), Shaun of the Dead (2004), Zombieland (2009), Planet Terror (2007), Red State (2011) and Cabin in the Woods (2012). Each are entertaining beyond belief, making fun of and yet homaging the genre. They don’t entirely fit the description of most disturbing because of their light-hearted nature but when done right, they’re some of the best horror out there.

All of the movies mentioned above I would absolutely recommend but none quite had what it took to take one of the top spots. In order to make an appearance on this list to defeat all other lists, you needed elements of all three subsets of the genre. And remember this isn’t the best horror movies but the most disturbing, or I guess you could say the scariest. Do the two often overlap? Surely, but let’s just make it clear what we’re talking about.

Each entry needed to be psychologically deafening, excessively visceral and dark beyond belief. They must hold you hostile to the fear, to the violence and to the unrelentingly black atmosphere. This list of the most distressing modern horror films tries to capture an element of panic, of sustained psychological horror and of palpable fear but more than anything, they’re movies that will break you down and leave you utterly shaken. Though it doesn’t really need to be said, this list is not for the faint of heart.

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13. I SAW THE DEVIL (2010, South Korea)

A deliciously devious tale of revenge, Kim Jee-woon‘s I Saw the Devil shows South Korea’s penchant for excessive ultraviolence amidst stunning technical workmanship. Kaleidoscopically epic, hopelessly violent and ruthlessly vengeful, this two-and-a-half revenge saga tells the tale of a special ops agent, Kim Soo-hyeon (Byung-hun Lee) who seeks retribution against the twisted serial killer (Mik-sik Choi of Oldboy) who raped and decapitated his pregnant wife. A few scenes of taunting torture surely lay down the tracks for this to stick with you at night but it’s the once good-hearted Kim’s transformation into a cold, calculated killer that really brings it all home. As he becomes a bona fide hunter of the criminally lecherous, Kim loses himself in a battle with his own soul. The blood drips bright stripes of red, complimenting the engrossing, challenging and yet playfully dark story from Hoon-jung Park. For those willing to go down a rabbit hole and be fully disturbed by their journey, I Saw the Devil is a must see.

12. THE DESCENT (2005, UK)

It takes a while for The Descent to ratchet itself up to a bona fide horror movie and yet the most cringe-worthy, WTF-level scenes come in the claustrophobic first half before any monsters scurry out of the darkness. Edged in the thicket of an impossibly tight crawlspace, set against the facade of a crumbling cavern, the only lights a sickening green sheen of Cyalume chemical light stick and backed in by the brine of murky, cruddy, bloody water, a gang of sheros attempt to escape a spelunking trip gone super duper bad. The movie is so thick with atmosphere, so masterfully set and impeccably lit, you feel like you’ve been dropped in the cave alongside this poor troop of unsuspecting badlasses. But by the time characters are swimming in pools of blood and nocturnal terrors scuttle through the pitch black, the enduring terror has already settled in.

11. TUSK (2014, USA)

Tusk is admittedly a bit of a mess. Kevin Smith doesn’t ever really commit to whether he thinks everything is a joke or not and gets mixed up with some French Canadian humor that falls flat on its face but it’s the sharp juxtaposition between the botched attempts at humor and the barbaric visual horror onscreen that makes Smith’s body transmogrification so fucking fucked up. The inhuman union between Smith and practical effects guru Alex Kurtzman birthed he-who-shall-not-be-named (cough, Mr. Tusk, cough) a protagonist sure to be amongst the freakiest incarnations of manimal to ever hit wide release. With Tusky in tow, Smith bombards us with a video collage of disquieting moans and groans that won’t ever seem to pipe down. The screams alone are doomed to forever rattle around my brain and yours. That’s because with Tusk, Smith performs a kind of Kafkaesque lobotomy. It’s “Metamorphosis” a la The Human Centipede. It’s The Fly meets Hostel. For those weak of stomach and mind, it might be advisable to bring a barf bag. Justin Long‘s grunting soundtrack should be enough to churn a tummy. And though it may often be sloppy, we should agree that one thing Tusk never is is toothless.

10. 28 DAYS LATER (2002, UK)

An incredibly stylized take on the zombie genre, 28 Days Later is frantic and innovative with a thrashing soundtrack and a nasty but thoughtful examination of human nature unbound by civilization. Critically acclaimed director Danny Boyle (Slumdog Millionaire) leaves his mark all over this edge-of-your-seat horror thriller, allowing it to transcend the bounds of your typical horror movie while still participating in the crazed bloodbath of it all. Perhaps the most incredible and disturbing part about Boyle’s descent into genre is that the zombie-like creatures at the forefront of his flick aren’t the most frightening part. Not by a long shot. It’s in the confines of man’s grasp that things really start to deteriorate and boy do they go off the handle here. Setting the course for the likes of The Walking Dead, Boyle’s twisted apocalyptic fantasy squeezes the dregs of humanity into a dirty playground, fills it with super-speed zombies and shakes it all up until it pops. Like a Pepsi plopped with Mentos, the ensuing madness will soak you down in a bath of frothy panic and is sure to stick with you for a long, long time.

9. ANTICHRIST (2009, Denmark)

It’s not really a list of grotesqueries without mentioning the infamous Lars von Trier is it? With aesthetics operating within the realm of the operatic and beautiful, Trier uses them for evil means. With Antichrist, Trier crams masochistic, grief-laden, genitalia-mutilating, pornographic, torturous snuff down his audience’s horrified throats. And yet the shots are utterly terrific. They’re hauntingly perfect. It’s like he’s captured that turning point where a dream reveals itself to be a nightmare all on celluloid. Only Lars can make a baby slipping out a window to his death look poetic and lovely. Antichrist is kind of like if The Shining were in the woods and the wife went crazy and smashed and cut her way through her and her hubby’s privates in order to escape the hell that is their life. After that sentence, it won’t be hard to convince you that this film is homework. It’s not one you’ll want to stick with. You’ll likely hate it. If you’ve already seen it, it’d be close to impossible to convince you to watch it again. Lars von Trier is a sick, twisted, perverse genius who knows how to make the most horrible things in life look beautiful and Antichrist will make you feel terrible for joining his world, if only for a few hours.

8. STARRY EYES (2014, USA)

Though still caught in the spokes of the genre festival rounds, Starry Eyes is a masterclass in disturbing its audience; one to keep your eyes peeled for if you’re in the mood to see eyes peeled. Blood-soaked, brutal and dejectedly campy, Kolsch and Widmyer’s sick story is a gnarled one set with snares primed to spring at every twisty, turny junction. As the campiness turns to outright villainy, Starry Eyes becomes such a horrifying victory because of the depths this demented duo are willing to go. This deep down the rabbit hole, everything is so pitch black that we can’t see even the faintest flicker of hope and they, in this realm of sensory deprivation, mine scares perfectly, with some third act body horror that’ll gross you out to the point of gagging. It’s the perfect synthesize of shock, shlock, disgust and angst that’ll have the most hardcore of horror buffs turning in their seats and watching through the crooks of their fingers.

7. BUG (2006, USA)

Bug is the kind of movie that you almost want to write off after watching it for a good while and then it happens and, holy dog shit Mondays, everything changes. The ungodly performances from Michael Shannon and Ashley Judd are definitively mesmerizing and seeing them wind themselves up until their tickers break is what makes the movie such an atrocious experience in utter madness. What starts as an off-kilter romantic thriller builds and builds and builds until it seems that it’s only going to be a movie made of mounting tension and no payoff but then BAM! like a .22 to the chest, it changes gear into an absolutely madhouse effort that’ll have you pumping the breaks to find they’ve already been cut. No one can help you now. Experience Bug in a dark room with the lights off, wade through what seems like endless exposition and you’ll find yourself rewarded with a cinematic climax that rivals that of William Friedkin‘s other work: The Exorcist. Yeah, I just went there.

6. THE MIST (2007, USA)

While the CGI monsters that lay the groundwork for this grocery store survival story are impressive only by 1990s standards, the story of slipping humanity and the mental cost of the apocalypse is an absolute jaw-dropper in The Mist. With a final moment that might go unparalleled in terms of its visceral gut-punch impact, this is a prime example of true psychological psychosis. Thomas Jane delivers a knockout performance and his last guilt-filled moment onscreen is so hard to watch, so filled with pathos and internal desolation, that it’ll be almost impossible to top in his entire career. I don’t recall an ending to anything that’s ever felt quite as horrifying and emotionally real as Jane getting his gun and popping off some ill-timed shots. It’s a scene that will stick with you whenever the film is mentioned and for good reason. Put simply, it’s the most distressing conclusion to a horror movie ever. Director Frank Darabont went on to make The Walking Dead and though his reign over WD never quite hit the same heights as The Mist, this oft forgotten gem should be sure to carve its way into your classic horror movie moments Hall of Fame.

5. THE LOVED ONES (2009, Australia)

The Loved Ones is your classic girl asks boy to prom, boy shuts girl down, girl’s dad captures boy and throws prom in living room, boy doesn’t have fun. With pitch perfect pacing and a completely demented sense of humor, The Loved One keeps you engaged with its perfect balance of sadism and black comedy. Forget gender, Robin McLeavy is one of the greatest horror movie heavies of the last decade with her sadistic smirks offering as many cringes as her incest-y relationship with daddy. Like Veruca Salt, McLeavy’s Lola (that’s Princess to you) is a girl who’s never been told no, even when she started to develop masochistic tendencies and harvest the hearts of the local boys. As twisted as it is hysterical, The Loved Ones is a perfect example of when camp transcends its whimsy and becomes something utterly discomforting. It’s an absolute home run from director Sean Byrne that’s sure to shock horror buffs, young and old.

4. KILL LIST (2011, UK)

Part crime thriller, part imploding family drama, all visceral horror, Kill List is an experience in unchecked fear. Perfectly paced and brilliantly directed, what begins as an ambiguous exercise in tension unfolds into a bloody road trip and explodes into a full blown panic attack. Questions pile up and answers are few and far between but Kill List is a movie that lends itself to deconstruction and theoretical questioning. Is it a religious parable about a modern day angel of vengeance? A commentary on an impending cultural apocalypse? Is it the devil’s coming of age tale? Or is it just threateningly vague to intentionally get you all in a tizzy? With music that is surely the soundtrack of Hell, Kill List burns itself into your subconscious and leaves just the kind of twisted questions doomed to keep you up at night. Not since Eyes Wide Shut has a cloaked cult seemed so menacing and real world and Kill List will have you questioning just what kind of evil might be hiding just next door.

3. INSIDE (2007, France)

Is there a more sympathetic mark than a pregnant woman? How about a pregnant woman whose husband unexpectedly passed away? How about about a pregnant woman whose husband unexpectedly passed away who just started going into labor? How about a pregnant woman whose husband unexpectedly passed away who just started going into labor and has had her home invaded by an shadowy, murderous force armed with a pair of sewing scissors? Nah, didn’t think so. Julien Maury and Alexandre Bustillo‘s Inside is home invasion by way of France, a merciless purge of all things good that must have fueled the French fake blood industry for its entire production. It’s the kind of movie that your local video store (and most certainly Netflix) shies away from so it’s not the easiest to find on the list but, holy monkey balls, if you do find it and want to put yourself through a ringer, this is where it’s at. Though it’s not really a movie that one can “spoil”, I’d recommend going into it as dry as possible. That way when you come out the other end splattered in bodily discharge, you’ll be all the more shocked and disturbed.

2. MARTYRS (2008, France)

The picture above should be enough to scare you away from Martyrs but if you’ve made it this far, it seems that you’ve committed to taking the plunge into the most perverse, disturbing territory possible so have at it. Martyrs is a film that must go unspoilt and yet necessitates a blaring warning sign. Again, look at that picture. If that’s enough to unsettle you, don’t even dream of seeing the film. Part revenge fantasy, part torture porn, Martyrs is so blissfully horrifying because, by the end, there’s a smidgen of justification behind the heinous accounts taking place on the screen. It will make you not only uncomfortable for having watched it but for thinking about the implications of it all. It’s by all accounts, an absolutely horrifying, definitively disturbing movie.

1. IRREVERSIBLE (2002, France)

And then there’s Irreversible, an almost impossible to watch experiment in brutal storytelling with loopy camerawork that warns you of the immensely nauseating events to come. For those looking to “go the distance” and really challenge yourself to watch something so horrifying and so heinous that it will literally seer itself into your nightmares, this is it. Last stop, everyone off. To its credit, Irreversible is an incredibly well done and viciously visceral film. Filmmaker Gaspar Noé backwardly tracking two men’s hunt for a rapist who’s brutally assaulted one of their girlfriends, Alex. The scene in question is shown without interruption and will make even the hardest stomach sink, securing a top spot as one of the most gut-wrenching atrocities ever set to film. Gratuitous almost seems like an understatement as Noé lets the camera roll on and on and on and on. If the cinematic somersaults and seizure-inducing strobing don’t make you sick, the content just might. Sure to send any man, woman or (god forbid) child over the edge of their sanity, Irreversible is a glaringly avant garde effort, a near brilliant art film so committed to its contrarian cause that it’ll happily spurn the leagues of those who do attempt to consume it. For the few with a stomach of iron though, Irreversible will surely join the ranks of most “fucked up” movies you’ll ever see and is certainly one of the most disturbing things you can settle down to watch.

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So in recap:

1. Irreversible (2002)
2. Martyrs (2008)
3. Inside (2007)
4. Kill List (2011)
5. The Loved One (2009)
6. The Mist (2007)
7. Starry Eyes (2014)
8. Bug (2006)
9. Antichrist (2009)
10. 28 Days Later (2002)
11. Tusk (2014)
12. The Descent (2005)
13. I Saw the Devil (2010)