According to Sean S. Cunningham the film was going to be named 'House III', but the new distributor, MGM, wanted a fresh start with potential new franchise, so the script was modified to reflect the new approach, and it was re-titled The Horror Show for the US theatrical release, and the title 'House III' was maintained for the non-US market.
The film was heavily cut for an R rating. Not only that some scenes were cut down but also some scenes were removed completely to avoid getting an X rating by the MPAA. Although the European cut features extra gore and violence, the fully uncut version was never released. Some stills show some scenes which were deleted and not included in any version of the movie; Bonnie's birthday scene where blood spills out of her birthday cake, scene showing Bonnie's dead boyfriend being torn in half, and scene where Lucas pulls his chest open and then his heart is shown.