Despite its whimsiccal storybook aesthetics, Fran Bow is filled with frightening images of violence and gore, and whiplashes between the two quite often. You'll be helping out a nice and friendly tree one moment, and seeing a ghastly image of a dead mother with a bruised and bloody stomach, surrounded by creepy children with bloodied faces - and worse still awaits you in this take on the "asylum escape" genre.
- The intro of the game shows the player the scene of Fran discovering her parents' recently-dismembered remains.
- Oswald Asylum itself is a very dreary and depressing location, especially considering the abuse of the mentally ill child patients, which includes the lobotomized and sickly children slowly dying in the basement. Due to Fran's innocence, when she comes across the latter, she does not realize what is going on.
- One of the mentally ill children Fran encounters, six-year-old Adelaida, is in the asylum after experiencing a near fatal sexual assault. When Fran is on duotine in Adelaida's room, she sees a doll-like version of her with bloodied handprints on her body where her breast and genitals would be. On the bed in the duotine version of Adelaida's room is similar bloodied handprints covering the bed in various places.
- Under duotine, Robert Clark is depicted with no eyes and a sewn-shut mouth. Eventually his head splits apart and leaves his neck gushing out blood.
- The first chapter of the game is the most gory; whenever Fran takes duotine in this chapter, both she and the player are greeted with the most graphic imagery in the game.
- Remor in general; a demonic figure with a horrifying presence that constantly torments Fran throughout the course of the game and had a role in the deaths of her parents.
- In the first part of the second chapter, Fran comes across the remains of an exterminator with insects crawling all over his skeletal remains.
- Dr. Oswald's experiments on twin children, both those stated outright and those implied. One of them involved the twins Clara and Mia, whom Oswald had sewn together a la Josef Mengele to see how their DNA would react. Clara and Mia's home directly alludes to it with a crib that has two live infants sewn together - the cries of the latter imply they are living in constant pain. The twins' section also has has a headless dead body lying on the floor.
- When on duotine during the Clara and Mia section, Fran ends up in a deep well. Near the bottom of the screen are very noticeable rotting remains. Later on, Dr. Deern reveals that when the twins died after Oswald's experiments on them, their remains were thrown into the same well, meaning these were likely the remains of the real Clara and Mia.
- In Ithersta, Fran is greeted with the vision of a rotting, ghostly version of her mother trying to speak to her (this is likely related to Remor tormenting Fran like he does through the whole game). Later on before leaving Ithersta, Fran sees a vision of herself stabbing Mr. Midnight.
- In Itward's flying machine, Fran sees another vision of her parents being sliced into several pieces and falling apart in front of her.
- In the final chapter, Fran encounters Remor's mother, Mabuka, and the residents of the latter's den, who can easily come off as frightening.
- Here, Fran learns about hijackers, creatures who resemble women in order to lure children. They are drawn towards children who smell like soap, in which they kill them and keep their heads. Fran encounters a creature that fits the description when she enters Mabuka’s Den.
- The vision Remor shows Fran of the latter murdering her parents. Whether this is the truth of what happened that night or Remor trying to mess with Fran's mind is up to interpretation.
