Based on the Japanese urban legend of Hanako-san, the spirit of a young girl who haunts school bathrooms, the film stars Takayuki Inoue, Ai Maeda, Yuka Kōno, Etsushi Toyokawa, and Nene Ohtsuka.

On her first day at a new school, a young transfer student named Saeko Mizuno is seen leaving the last stall in the girls' bathroom.

Students at the school believe that a young girl named Hanako-san committed suicide in that stall, and that her spirit remains there.

She summons a mob of students to the school, and they surround the killer, preventing him from escaping until the police and other adults arrive.

In his book Flowers from Hell: The Modern Japanese Horror Film, author Jim Harper writes: "Although it's difficult to imagine American or European parents allowing their offspring to watch a film in which young children are terrorized by a serial killer, Toire no Hanako-san is easily the best of the Japanese horror movies aimed at pre-teen audiences.