After nine Saw movies, you know what you’re in store for with Saw X, the latest edition to the long-running torture-horror series that opens in cinemas worldwide this weekend. But someone, somewhere out there is in for quite a surprise when this downbeat version of Ikiru abruptly shifts gears halfway through to become the most sickening thing they’ve ever seen.

Yes, the entire first half of Saw X is dedicated to the Jigsaw serial killer, John Kramer (Tobin Bell), going through the stages of grief following a cancer diagnosis that ultimately leads to him seeking treatment in Mexico. Sure, he briefly fantasizes about a death trap involving a vacuum cleaner sucking out a hospital orderly’s eyeballs, but otherwise the majority of the running time is dedicated to MRI scans, doctor visits, support groups, and Jigsaw coming to terms with his own mortality after taking dozens of lives.

But when John comes across a fellow survivor who has miraculously healed (Michael Beach), he’s turned onto a potential cure from a Norwegian doctor who promises a revolutionary mixture of surgery and a drug cocktail. The doc is on the run from big pharma, but his daughter Cecilia (Synnøve Macody Lund) happens to be performing surgeries in Mexico, and just might be able to fit John in her schedule.

We know where this is all going, but Saw X goes to great lengths to sell the miraculous cancer cure to the audience as well as Cecilia sells it to John. Lund’s unexpectedly empathetic performance goes a long way towards us buying into the fact that this may really be a different kind of Saw movie, and it makes her heel turn hit even harder.

Of course, Jigsaw is soon up to his old games, and this time it’s really personal as he’s left with a group of scam artists who fleece dying cancer patients out of their life savings. And so, halfway through Saw X, we’re treated to the film’s showstopping torture sequence as poor Valentina (Paulette Hernandez) is forced to sever her leg at the thigh and shove a suction tube into her freshly-sectioned bone as marrow is sucked out and dripped onto a scale that will prevent a bandsaw from slicing off her head.

It’s turn-away-from-the-screen disgusting stuff, and the reason that people watch these movies… and chillingly effective meta-commentary. Jigsaw and his accomplice Amanda (Shawnee Smith) will go on to torture Mateo (Octavio Hinojosa), who is forced to cut out a piece of his own brain, and Gabriela (Renata Vaca), who is cooked by a chemotherapy machine, before setting their sights on the good doctor.

But this time, things are a little different. Saw X takes the form of a revenge film, and goes to great lengths to justify Jigsaw’s actions: in general movie logic, we’re rooting for these people to get their comeuppance. And when they suffer their unrelentingly gory fates, the movie is also asking us to look inward. Are we not entertained?

Saw X is one of the more interesting Saw movies and one of the best in the franchise, perhaps second only to Saw III. And after a departure for the series in the form of Jigsaw and a near-complete reboot in Spiral: From the Book of Saw, fans will find a lot to like here: Jigsaw gets more screentime here than in any previous film, and Bell makes the most of it.

Saw X was directed by Kevin Greutert, who edited the first five movies in the franchise, directed Saw VI and Saw 3D, and edited Jigsaw. It’s safe to say he knows his way around the material. The timeline of the Saw movies is notoriously mangled (and even more contrived than Jigsaw’s death traps), but the events of Saw X appear to take place both before the original Saw, and up through the second or third movies in the franchise.

Alongside Fast X, Saw X is the second 2023 movie that represents the tenth entry in a series. We may have not needed ten Saw movies. But if you’re looking forward to this one after seeing the previous nine, it’s safe to say you won’t be disappointed.