Pyramid Head is back, this time with someone tough enough to fight him. This someone is the superbly-designed blade-headed slasher character, known as The Missionary (and obviously deserving of a better name). This is among the most impressive creature/character designs I've yet seen in movies, and nearly as innovative as Mr. Head, and arguably more dangerous, given her speed. The murderous nurses are also back, this time even more glorious than before.
Sadly, there is nearly nothing else to celebrate... the direction is quite bad (deceptive and erratic camerawork and editing with annoying overuse of the tired trademark of horror movies... loud sounds). The leading lady, and his boyfriend, are not interesting. Sean Bean is a good actor, but is seriously miscast, as he was in the previous movie. There's lots of meh dialog, but I really did love the leading lady's moment in the classroom, which is something I've never seen before in movies. But because the script isn't solid, her attitude (and strength of character) was left unexplained, and is simply over-the-top.