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9 Extreme Horror Books with Heart

These depraved books are intense reads—but their gore and violence are not gratuitous.

Extreme horror books with heart, including Woom by Duncan Ralston
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  • Photo Credit: Woom by Duncan Ralston

Extreme horror is exactly what it professes to be—extreme. These stories take the most grotesque subjects and go elbow deep into the viscera of them. It isn’t for fun, or to take the horror out of things like torture, abuse, or sexual depravity. In fact, it’s often the opposite. By diving deep into these subjects and examining the absolute awful nature of the people involved, it helps readers confront the monsters that would prefer to stay hidden in the dark.

It goes without saying that this genre is not for everyone. No subject is off-limits in extreme horror. It’s possible to live through terrifying and brutal events through the eyes of the killer, the victim, or a witness helpless—or unwilling—to stop the crime from unfolding. You should know your gore and trauma tolerance before going in, and always assume that an extreme horror book will likely have all the trigger warnings. 

If you’re still with us, and extreme horror in all its depravity is your jam, we’ve gathered eight extreme horror books with extreme heart. These stories offer a glimpse at how to hold onto your humanity, even when you’re stuck in the depths of atrocity.

Related: Why Empathy in Horror Makes for Better (and Scarier) Movies

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The Girl Next Door

By Jack Ketchum

The suburbs in the 1950 seems like an idyllic place to grow up. After Meg and Susan’s parents die, they go to live with their Aunt Ruth on a quiet street with her three sons. But the pressure of five kids soon takes its toll on Ruth. She begins punishing Meg and Susan in horrific ways, allowing her sons—and even kids from the neighborhood—to torture, starve, and humiliate the sisters. One boy refuses, desperate to save the one girl he’s ever loved.

This harrowing story is loosely based on the gruesome real-life murder of Sylvia Likens. The scenes are heartbreaking and violent, devolving into a grim account of brutal child abuse that may be too much for some readers. Told through the eyes of teenage David, we see how devastating it is to be helpless—and how much bravery it takes to confront true evil.

brother ania ahlborn female horror writers


By Ania Ahlborn

The Morrows live in an old farmhouse deep in Appalachia. They keep to themselves, so much so that when a girl goes missing on the highway, no one comes to ask them anything. Given what’s in their backyard, it’s best everyone stays away. Nineteen-year-old Michael is different though. He wants to escape to a life where screams don’t filter through the trees. When he meets a young girl working in the nearby town, he almost forgets he’s supposed to be a monster. But his brother won’t let him forget.

While Ahlborn doesn’t hold back on the disturbing violence, she manages to create an extremely empathetic character next to incredibly vile monsters. This book will simultaneously break your heart and induce deep anger, only to culminate in a shocking and bloody end.

Woom by Duncan Ralston


By Duncan Ralston

Room 6 in the Lonely Motel holds more secrets than the rest of the motel. Angel’s mom died in that room. He’s researched the history and is ready to confront the pain and tragedy trapped inside it. He calls a plus-sized prostitute to the room to make sure the stories live on. Shyla doesn’t believe half the stories Angel tells her are true. How can they be? But the Lonely Motel remembers everything—including taking its victim.

Technically, this story is more novella than novel, but the absolute horror held within its pages makes up the length difference. Ralston makes sure you care about Angel and Shyla, building the dread by pushing boundaries in all directions. He highlights the emotional pain of trauma through visceral depravity in a way that is guaranteed to haunt you long after you close the cover.

The Groomer by Jon Athan

The Groomer

By Jon Athan

When Andrew McCarthy catches photographer Zachary Denton taking pictures of his daughter and other children at the park, he is immediately concerned for his family. Then Zachary starts showing up at the local diner, and then the grocery store, and Andrew knows none of these are a fluke. And then his daughter disappears. After leads dry up and the police are inept, Andrew starts searching for sex offenders in the area and learning interrogation techniques. He believes he’ll do anything to rescue his daughter. But he may not be ready for the sheer evil he’ll not only face but have to become in order to save her.

The Groomer is a dark and disturbing story into the depraved world of child predators and sex traffickers. Even when Andrew seeks his own version of justice, the violence and gore doesn’t let up. On every level, the trauma is unbearable, and the brutality is difficult to read, but you never stop rooting for this father to succeed.

best horror books of 2020

Tender Is the Flesh

By Agustina Bazterrica

The “Transition” happened fast. After an infectious virus made animal meat poisonous to humans, the government deemed human meat “special”. Marcos doesn’t like to think about what he does at the local processing plant, where no one calls the people he slaughters human anymore. Then one day he’s given a live specimen to raise for his own consumption needs. Treating her with any compassion could mean his death. But is he willing to lose his humanity entirely?

From the beginning, Marcos is a sympathetic character. He takes us through the intricate horrors of devolving into a cannibalistic society, but it’s the bureaucracy and mundanity that take the terror up to absolutely shocking heights.

Related: 15 Best Horror Books of 2020

gone to see the river man

Gone to See the River Man

By Kristopher Triana

Everyone knows rock stars and actors get super fans. Even stalkers. But so do serial killers. Lori is obsessed with one serial killer in particular: Edmund Cox. She starts writing him letters and they develop a relationship. She’s so thrilled that when he asks her for a favor, she promises she’ll do anything. And the task seems simple enough. Go to a cabin in the Killen woods and take a key to The River Man. But the journey requires much more than of Lori than she first understands—and proving she’s worthy of a maniac's love will take even more.

Through two timelines, the journey forces Lori to confront the dark secrets of her past. We’ve all heard the saying, “be careful what you wish for,” and while we watch Lori hurtle toward the end, we hold our breaths to see what fate she’ll meet—and if it’s the one she deserves.

Related: 8 of the Most Underrated Horror Books of All Time

Kin by Kealan Patrick Burke


By Kealan Patrick Burke

Claire Lambert was found nearly dead on the side of the road. Naked and bleeding, she’s the only survivor of the brutal Elkwood Massacre. But she wasn’t the only victim. Thomas returns from the Iraq War to find his brother died at the hands of the Merrill family and Pete can’t find a place he belongs now that his father is dead. They live in the aftermath of brutal violence but when guilt and grief converge into the need for revenge, it may be time for them all to go to Elkwood.

Kin is as close to a slasher movie as a book can get. By starting at the end, we are able to watch the character explore the effects of their traumas while living through the violence through flashbacks. It’s about redemption and revenge, but also learning how to live through trauma.

books like penny dreadful

Exquisite Corpse

By Poppy Z. Brite

After Andrew Compton fakes his own death to escape from prison, he heads to the U.S. He believes murder is art and is seeking to push himself in new and unexpected ways. He meets Jay Byrne, a playboy who also considers himself Compton’s brand of artist, and together, they begin hunting the perfect victim. But their victim has a complicated past—an ex with an agenda—and it threatens their pursuit in shocking and unexpected ways. All four of their paths align on a single bloody night, where they’ll either die or be forever changed.

There are a lot of stories about serial killers, but Brite doesn’t only take us into a killer’s mind, he creates a morbid love story. The writing is lush, making it completely at odds with the subject matter, and yet the result is a hypnotic novel you won’t be able to put down.

the long walk by stephen king, a psychological horror book

The Long Walk

By Stephen King

America is no longer the land of the free. It’s a police state where every year, one hundred boys are forced to enter a contest where the winner gets anything he wants for the rest of his life. The rules are simple: walk at a steady pace of four miles per hour. Don’t stop. Don’t get more than three warnings. If you do, you die.

Perhaps The Long Walk by Stephen King isn’t technically extreme horror. It has its fair share of gore, but the extremity is simply in enduring the endless walk with Ray. It’s a slow descent into how anything can become extreme under the right conditions—and the emotional toll of that endurance leaves disturbing footprints in your psyche.