Some of the creature design which is quite good, best of which is Pyramid Head, the horrific blade-dragging monster, whose made even more memorable by his countless bug-like companions. Second favorites are the supersexy, faceless, murderous nurses. These pleasures were however spoiled by a miscast/unconvincing villainous lady and the weak story. This is not to mention random stupid things, like the leading lady running away from the cop for no reason, or the silly gal whose hate leads to her being skinned alive, etc.
This is how I felt first time I watched it, and is no longer the case:
Deserving of mention is the superb production design (though this is inconsistent) and certain moments of extreme beauty (e.g. the early scene of the grassy wilderness where mother and daughter share some love, and a later scene which shows the internals of the family's home). As for visual effects, the moments of "approaching darkness" can only be a result of visual mastery.
That early scene was nice yes, but calling it extremely beautiful is extreme. As for the visual mastery comment, it must have been mere virgin excitement.