The film picks up 40 years after the original massacre at the secluded rural asylum, Stephens Sanitarium. The only survivor of the previous rampage, the now elderly Dr. Charlotte Beale (played by the same actress, Jessie Lee Fulton, from the original), returns to the institution, which has reopened and is under new management. However, the dark and violent history of the asylum seems to repeat itself. As new patients and staff arrive, the terrifying secrets of the past resurface, leading to a new wave of madness, murder, and depravity within the walls of the asylum, suggesting that the evil was never truly contained.
