Criminal Edgar Munsen is pursued by the police onto a rooftop, where he activates a triggering mechanism before being shot non-fatally by Police Detective Halloran and his fellow officers.
Five people are held captive in a barn, each with a metal noose around their neck. A tape recording from John Kramer explains they must give a sacrifice of blood and will need to confess their sins. The chains begin pulling them towards a wall of buzzsaws. Four manage to survive by cutting themselves on the blades as an offering of blood, but one man who was unconscious during the majority of the game appears to die.
The next test divulges that group member Carly caused the death of an asthmatic woman by stealing her purse, which had her emergency inhaler inside. To save the others from being hanged, she must inject herself with one of the three needles- one containing an antidote to a poison in her system, one a saline solution, and one a potent acid. Volatile group member Ryan eventually stabs Carly with all three to save himself, melting her face and killing her.
Detectives Halloran and Hunt begin investigating the discovery of bodies that appear to belong to the unnamed man and Carly. Halloran becomes suspicious of forensic pathologists Logan, a veteran and former doctor whose wife was killed two years prior, and Eleanor. Munsen is kidnapped from the hospital by an unseen assailant. When the police commissioner orders Kramer’s grave be exhumed, Munsen’s dead body is found inside instead.
Ryan tries escaping through a door marked “No Exit”, and is trapped by wires that ensnare his leg. Fellow group members Anna and Mitch discover an unlocked door, and are trapped inside a grain silo. A taped message explains they will be buried in grain and killed by falling debris unless Ryan pulls a lever that will free him from the wires around his leg. Anna and Mitch survive, but Ryan’s leg is severed when he pulls the lever.