An unnamed homicide detective interrogates a dazed hospital orderly named David. The young man is handcuffed, and his shirt and face are smeared with blood. When the officer asks what happened to him, David tells him a shocking story.
The events taking place before the interrogation are depicted in flashbacks. When David ends his shift at the hospital, he is knocked unconscious and abducted by an unknown person. He later awakens and finds himself strapped to a chair in a large room with a heavy metal device locked onto his head. Only mere seconds later, a TV turns on next to him. A mechanical ventriloquist puppet appears on-screen and tells him that the device on his head is hooked into his upper and lower jaws and will tear his head apart, describing it as a "reverse bear trap." David's only way to escape this fate is to find a key hidden in the stomach of his supposedly dead cellmate.
After receiving his instructions, David successfully frees himself from the chair but accidentally activates the trap's timer in the process. Across the room, David eventually finds the body of his cellmate. However, when he approaches him and prepares to cut him open with a knife lying next to him, David realizes that the man is not dead but merely paralyzed. Nonetheless, David eventually eviscerates him and manages to find the key and unlock his trap only moments before the timer goes off.
Shocked by what he had done, David starts to scream but stops when the puppet from the video suddenly appears and approaches him on a tricycle. The doll congratulates him for his survival, telling him that he had learned to be grateful for his life.
When he finishes his story, the police officer asks David if he is grateful for his survival. David, however, bursts out crying again before he can answer. In the final scene, a dilapidated bathroom is seen with an eye looking through a hole in the tiled wall.
Before 2003, James Wan and Leigh Whannell wrote a horror film script, citing inspiration from their dreams and fears. Upon its completion, Wan and Whannell wanted to select an excerpt and film it to pitch their film to studios. With the help of Charlie Clouser, who had composed the score for the short film, and a few stand-in actors, Whannell and Wan shot the movie with a relatively low budget. Whannell starred in the film as well in the role of David.
When they sent it to Lions Gate Entertainment, the producers Oren Koules, Mark Burg, and Gregg Hoffman were so impressed by the short film that they decided to produce the feature film of the same name, which started the successful Saw saga. When Saw was eventually released on Blu-ray and DVD, the short film was included as a bonus feature.
- The same sound from the introduction of the title can also be heard in the song Screaming Slave by Nine Inch Nails. Charlie Clouser, who composed the soundtrack for the movie series and the short film, has been a part of the band during live performances.
- Unlike his counterpart from the feature films, the version of Billy the Puppet seen in the short movie wears a bowler hat.
- David's test is almost identical to Amanda Young's game in the first Saw film.
- Leigh Whannell, the actor playing David, also played the role of Adam Stanheight, one of the main protagonists of the first film.