Harold Pinter adapted it as a screenplay for a film directed by Paul Schrader in 1990 (The Comfort of Strangers), which starred Rupert Everett, Christopher Walken, Helen Mirren and Natasha Richardson.

Although the guests are at first shown great hospitality, it becomes clear that the hosts have a peculiar relationship with each other – Robert is the product of a sadistic upbringing and Caroline, who is disabled, has an uncomfortable masochistic view of men as being masters to whom women should yield.

As she slowly begins to understand what Caroline and Robert have in mind with Colin, she starts to feel very tired and falls asleep.

Second, Robert's acts are placed in the context of his childhood, suggesting that his family upbringing with a domineering, authoritarian father, submissive mother and older, more powerful sisters, was responsible for his behaviour.

McEwan scholar David Malcolm argues that reviews for The Comfort of Strangers were positive, noting that James Campbell of New Statesman praised it as a "fine novel" and that a number of critics (including Anthony Thwaite) deemed it superior to McEwan's previous novel The Cement Garden (1978).

[2] In the London Review of Books, Christopher Ricks wrote that "McEwan’s tale is as economical as a shudder" and discussed the alarm of English critic John Ruskin about the ubiquity of death in modern novels, arguing that “the cutting force of the story is in its laying bare how ineradicable is this shock that it should be the mostly inoffensive and mostly respectable whom such horrors befall.” Ricks lauded the ending as emotionally affecting.

A writer for Kirkus Reviews stated that although the "first half promises important fiction", the book ends in a "a kinky, symbolic sexual situation which is neither effective as storytelling nor freshly resonant as metaphor”.

The elegance of McEwan's readabiltiy [sic] and technical skill – invariably much admired – have been brought to a higher luster and intricacy.

However, the reviewer also argued that "all this skill is directed toward a climax which, even though it is duly horrific, is sapped by a certain thinness and plain banality at its core",[5] writing that the short story "Psychopolis" from McEwan's collection In Between the Sheets covers the same themes more effectively.

Leonard argued, "No reader will begin The Comfort of Strangers and fail to finish it; a black magician is at work.