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Director Wes Craven and screenwriter Bruce Joel Rubin's original vision for the film was a PG-rated supernatural science fiction thriller, with the primary focus being on the macabre love story between Paul and Samantha, as well as a secondary focus on the adults around them and how they are truly monsters inside themselves. Craven filmed this version of the film and Warner Bros. decided to screen it to a test audience mostly consisting of Craven's fans. The response from fans was negative, criticizing the lack of violence and gore seen in Craven's previous films. The studio eventually discovered Craven's popularity as a horror film director. The president of Warner Bros. at the time, Mark Canton, demanded Rubin write six additional gore scenes into his script, each bloodier than the last. Rubin worked very hard with Craven to create a very deep and heartfelt movie out of it. Unfortunately, added gore scenes, re-shoots and post production re-editing of the movie heavily changed the original story. Craven and Rubin expressed strong anger at the studio and thus disowned the film.

Sam would have had her head shaved prior to her brain surgery.

The original release of the movie contained cuts which were implemented by the MPAA in order to prevent an X rating. Scenes for which movie kept getting X rating were all the gore scenes which were re-shot by studio orders. Movie was submitted to the MPAA 13 times before it finally got an R rating. Uncut scenes have been restored on the DVD release from the Twisted Terror Collection released by Warner Bros. on Sept. 25th, 2007. These scenes are:

• When Samantha is dreaming about her father coming into her bedroom and she breaks a vase and stabs him with it, close-ups of Sam's face getting hosed with blood are present.
• After Samantha murders her father in the basement boiler, Paul comes in and pulls the upper half of his body from the boiler and you get several more seconds and close-ups of his charred skeletal face.
• The infamous 'basketball' scene in which Samantha kills Elvira with a basketball is extended to show more of Elvira's head exploding all over the wall and her headless body walking directly from the wall instead of cutting back to Samantha's face and then showing the body walking around as in the VHS release.

Featured in The Directors: The Films of Wes Craven (1999)