Directed by

Christian Alvart
Made by
Paramount Pictures
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Read the complete plot summary and ending explained for Case 39 (2010). From turning points to emotional moments, uncover what really happened and why it matters.
As social worker Emily Jenkins becomes involved in the troubled life of Lillith Sullivan, a 10-year-old girl, she uncovers a disturbing reality filled with neglect and psychological trauma that has deeply impacted Lillith’s fragile state of mind. Tasked with examining the Sullivan family dynamics, Emily soon identifies patterns of emotional overprotection and suffocation that appear to have stunted Lillith’s growth. The alarming depth of the situation is confirmed when Emily discovers that Lillith’s parents attempted to roast her alive in their oven, a horrifying act that compels Emily, along with Detective Mike Barron, to intervene and rescue the child from their clutches.
In an unexpected twist, the court places Lillith in Emily’s care until a permanent foster placement can be arranged. As Emily and Lillith begin to adapt to their new living situation, a series of eerie incidents disrupt Emily’s life. Just two weeks later, a grim case involving another boy, Diego, takes an unsettling turn when he murders his parents, revealing that a call had been made from Emily’s residence on the night before the crime. With her credibility in question, Lillith is evaluated by Dr. Douglas J. Ames, Emily’s friend, who is soon ensnared in Lillith’s manipulative games.
During their session, Lillith adeptly flips the interrogation, prying into Douglas’s inner fears and leaving him unnerved. That evening, Douglas receives a haunting phone call and finds himself terrorized when a swarm of hornets bursts from his body, leading him to a tragic end as he seeks an escape from the unexplainable horror surrounding him. Concerned about Lillith’s overpowering influence, Emily investigates the mental asylum where Lillith’s parents are incarcerated, only to uncover the shocking truth: Lillith is a sinister being that consumes emotions, and her parents’ extreme actions were desperate attempts to break free from her supernatural hold.
In a chilling climax, Emily learns that the key to stopping Lillith lies in putting her to sleep. Just as she leaves the asylum, tragedy strikes again—Lillith’s mother perishes in flames while her father suffers a gruesome fate, impaled in the eye by a fork. As Emily traverses this dangerous path, she must confront the dark forces lurking in the shadows, striving to reclaim her life from the grip of this demonic child.
As Barron grows increasingly worried about Emily’s psychological state, a cryptic phone call from Emily’s own cellphone—now in Lillith’s possession—validates his growing fears. Taking action, Barron prepares to assist Emily, but a shocking incident occurs when Lillith manipulates him into accidentally inflicting a fatal wound upon himself. This bleak turn deepens Emily’s struggle against Lillith’s malign influence.
Refusing to be dissuaded by her recent trials, Emily devises a drastic plan with Barron’s unintentional aid. That night, she adds sedatives to Lillith’s tea in hopes of quelling the demonic presence, but when Lillith succumbs to sleep, Emily takes a drastic measure, attempting to incinerate their shared home, believing this will finally end Lillith’s terror. However, to everyone’s astonishment, Lillith escapes unharmed.
Despite authorities offering refuge to both Emily and Lillith, Emily veers off course, engaging in a high-stakes pursuit against her adversary. With reckless abandonment, she races towards a pier, intent on invoking fear within Lillith. The vehicle plunges into the water, where Emily struggles to contain Lillith within the trunk. In a desperate moment, she abandons the sinking car and swims to safety, only to have Lillith grasp her leg in a last-ditch effort to drag her back.
Finally breaking free, Emily emerges from the water, burdened by the weight of her choices. Her nightmare appears to conclude when Lillith meets her end in the submerged vehicle, yet a chilling postscript in the DVD’s Special Features reveals that a shadowy figure rescues both Lillith and Emily from the depths.
In a shocking aftermath, Emily finds herself in handcuffs, begging her lawyer for information on Lillith’s fate. Her lawyer remains indifferent to her pleas, leading to her institutionalization for schizophrenia while Lillith embarks on a new and dark chapter with a different foster family, hinting at the continued malevolence that surrounds her life.
Follow the complete movie timeline of Case 39 (2010) with every major event in chronological order. Great for understanding complex plots and story progression.
Emily Jenkins becomes involved with Lillith
Social worker Emily Jenkins begins her investigation into the life of 10-year-old Lillith Sullivan, a child showing clear signs of distress and neglect. As Emily delves deeper, she identifies the severe psychological trauma affecting Lillith's mental state.
Discovering the Sullivan family dynamics
Emily examines the family dynamics within the Sullivan household, revealing patterns of emotional overprotection and suffocation that significantly hinder Lillith's emotional growth. The environment proves to be a hostile one, contributing to the child’s fragile state.
The horrifying revelation
Emily uncovers a chilling truth when she learns that Lillith's parents attempted to murder her by roasting her alive in their oven. This shocking discovery prompts her to take immediate action to ensure Lillith’s safety from her negligent parents.
Lillith placed in Emily's care
After the traumatic event, the court decides to place Lillith in Emily's care until a permanent foster placement can be arranged. This decision opens a new chapter for both Emily and Lillith as they try to adapt to their new living situation.
Eerie incidents begin
As Emily and Lillith settle together, strange and eerie incidents begin to disrupt their life. Emily becomes increasingly aware of the unusual and dark occurrences surrounding them, leading to questions about Lillith's influence.
The tragic case of Diego
Emily learns about the tragic case of a boy named Diego, who murders his parents under troubling circumstances. Disturbingly, a call had been made from Emily's residence the night before the incident, casting doubt on Emily's credibility.
Dr. Douglas J. Ames evaluates Lillith
Concerned for Lillith's troubled mind, Emily enlists the help of her friend Dr. Douglas J. Ames for an evaluation. In their session, Lillith manipulates Douglas, exploiting his vulnerabilities and leaving him significantly rattled.
Douglas faces a terrifying incident
That evening, Douglas receives a sinister phone call and is horrified by a bizarre attack involving hornets erupting from his own body. This gruesome incident leads to Douglas's tragic demise, heightening the horror surrounding Lillith.
The truth about Lillith's parents
Emily investigates the mental asylum where Lillith's parents are confined and uncovers a shocking revelation: Lillith is a malevolent being that feeds on the emotions of others, driving her parents to desperation. This discovery complicates Emily's efforts to protect Lillith.
Emily's desperate plan
In a bid to confront Lillith's overpowering influence, Emily devises a drastic plan to put the child to sleep using sedatives. However, the dangerous game she plays escalates as she contemplates incinerating their shared home to eliminate Lillith’s terror.
The car plunge
During a high-stakes confrontation, Emily drives her car into the water while trying to contain Lillith. Here, she struggles against the child, who clings to her leg in a final attempt to drag her back into the depths.
Emerging from the water
After an intense struggle, Emily breaks free and swims to safety, momentarily believing she has escaped Lillith’s clutches. However, the fear remains as the dead child's possible fate leaves Emily in distress.
Emily's lawyer reveals grim news
Emily faces the shocking aftermath of her recent choices when she finds herself in handcuffs, begging her lawyer for information about Lillith. To her dismay, her lawyer's indifference leads to her institutionalization under allegations of schizophrenia.
Lillith's fate is revealed
In a chilling turn, the conclusion indicates that despite Emily’s attempts to rid the world of Lillith, the child is rescued by a shadowy figure from the depths. The implication of continued malevolence haunts the ending.
Explore all characters from Case 39 (2010). Get detailed profiles with their roles, arcs, and key relationships explained.
Emily Jenkins (Renée Zellweger)
Emily is a dedicated social worker whose compassion drives her to intervene in Lillith's turbulent life. However, as she becomes ensnared in Lillith's manipulative web, her mental state deteriorates, revealing her fragility. Emily's transformation from a caring protector to a desperate survivor highlights the intense psychological strain she experiences.
Lillith Sullivan (Jodelle Ferland)
Lillith is a complex and sinister character, appearing innocent while embodying dark psychological manipulations. Her past trauma leads to disturbing behaviors, making her a chilling presence in the story. As she consumes the emotions of others, her character generates both sympathy and fear, complicating the narrative's emotional landscape.
Dr. Douglas J. Ames (Ian McShane)
Dr. Ames is a friend of Emily's, who becomes inadvertently caught in Lillith's dangerous games. His initial role as a supportive figure shifts as he faces his own fears, placing him in a vulnerable position. The character's arc reflects the unpredictable nature of dealing with trauma and manipulation.
Learn where and when Case 39 (2010) takes place. Explore the film’s settings, era, and how they shape the narrative.
Time period
The movie unfolds in a contemporary setting, highlighting modern societal issues such as child welfare and psychological trauma. This immediacy enhances the horror elements, lending authenticity to the characters' emotional struggles. The narrative's timeline is marked by critical events that escalate the suspense and horror.
Location
Emily's residence, asylum, pier
Emily's residence serves as both a temporary refuge and a battleground for psychological horror. The asylum is a place of confinement that holds the disturbing secrets of Lillith's parents, adding to the atmosphere of dread. The pier acts as a dramatic setting for the climax, symbolizing Emily's desperation and the depths of her conflict with Lillith.
Discover the main themes in Case 39 (2010). Analyze the deeper meanings, emotional layers, and social commentary behind the film.
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Fear and Manipulation
The movie explores the theme of fear as Lillith manipulates those around her through psychological tactics, instilling dread in both Emily and the supporting characters. This manipulation stems from Lillith's traumatic past and her sinister abilities, reflecting the complex nature of psychological horror. The interplay between perceived safety and underlying terror is central to the narrative.
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Mental Health
Mental health is a prominent theme, as the film addresses issues like neglect, trauma, and the stigma surrounding psychological illness. Emily's struggle with her mental state, especially following Lillith's manipulations, emphasizes the thin line between sanity and madness. The portrayal of institutional responses to mental health also raises critical questions about treatment and understanding.

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Discover the spoiler-free summary of Case 39 (2010). Get a concise overview without any spoilers.
In a stark, rain‑slick suburb where the ordinary masks hidden anguish, Emily Jenkins works as a social‑service caseworker hardened by years of confronting humanity’s darkest moments. Her routine investigations have taught her to expect neglect, abuse, and the quiet desperation that lives behind closed doors. Yet when a call leads her to a modest home on the edge of town, she meets Lilith Sullivan, a ten‑year‑old whose timid demeanor hints at something far more unsettling than ordinary hardship. The brief encounter sets a new tone for Emily’s career, pulling her into a world that feels both familiar and profoundly disquieting.
The film unfolds in a palette of muted blues and cold interiors, letting the silence between characters speak louder than any dialogue. As Emily steps deeper into Lilith’s life, the atmosphere grows increasingly claustrophobic, underscored by the lingering sense that the girl’s circumstances are tangled in layers of deception and unspoken terror. The narrative invites viewers to feel the weight of responsibility that settles on a caretaker’s shoulders, while also hinting at unseen forces that twist ordinary family dynamics into something almost surreal. The tension is sustained not by explicit horror, but by the unsettling possibility that the worst of human behavior may be something far more insidious and deeply personal.
Through careful observation and a growing empathy, Emily finds herself drawn into a delicate dance of protectiveness and curiosity, balancing professional detachment with a fierce, almost maternal instinct to shield the frightened child. The story’s pacing mirrors her investigative journey: deliberate, methodical, and punctuated by moments of unsettling revelation. As the two women navigate a maze of hidden truths, the film maintains a haunting, introspective mood, leaving the audience to wonder how far the shadows of manipulation can reach—and whether someone can truly escape the grip of a terrifying circumstance without being changed forever.
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