The plot focuses on two female students who drive to one of their family's secluded farmhouses to study for their exams, where a murderer shows up on the night of their arrival.

High Tension was theatrically released in France on June 18, 2003, and was screened at the 2003 Toronto International Film Festival as part of the "Midnight Madness" section, where it was acquired by Lions Gate Entertainment.

Marie, hearing the mother's screams, quickly arranges the guest room to make it appear that no one is staying there, and hides under her bed.

After hearing loud thuds, she hides in the closet and through the slats of the door witnesses the killing of Alex's mother as her throat is brutally slashed with a razor.

When the killer comes into the shop, Marie hides and she witnesses the store clerk Jimmy being murdered with an axe.

Sometime later, Marie is in a psychiatric hospital room chained to her bed, with Alex watching her through a one-way mirror.

[9] In the United States, Lionsgate released an English-dubbed version of the film in 1323 theaters on 10 June 2005 (with $14 million marketing cost).

[10] A re-cut theatrical trailer was released by Lionsgate to promote the film, featuring "Superstar" by Sonic Youth.

[12][5] The R-rated edition was released in American cinemas, in a less widely circulated fullscreen DVD, and on the streaming service Tubi.

This section notes what was deleted from the unrated, original French film to produce the American version.

The consensus states: "There is indeed a good amount of tension in this French slasher, but the dubbing is bad and the end twist unbelievable.

"[16] Lisa Nesselson of Variety was more forgiving, saying that the film "deftly juggles gore and suspense", has "unnerving sound design", and "has a sinister, haemoglobin look that fits the story like a glove".

There's a lot of intelligence in both the script and in Alexandre Aja's direction ... For those who enjoy horror films and don't mind copious quantities of red-dyed fluids, this one is not to be missed.

"[10] The Village Voice's Mark Holcomb wrote that the film resembles "a pastiche of '70s American slasher flicks that seemingly stands to add to the worldwide glut of irono-nostalgic sequels, remakes, and retreads," ultimately seeing it a "gratifyingly gory, doggedly intellectual decon of the likes of The Texas Chainsaw Massacre, Halloween and (surprisingly but aptly) Duel.

[22] On his website, Koontz stated that he was aware of the comparison but would not sue "because he found the film so puerile, so disgusting, and so intellectually bankrupt that he didn’t want the association with it that would inevitably come if he pursued an action against the filmmaker.