On her way home with her best friend Yoshie Kazuya (Aika Ota), Tsukiko runs into her elder sister Tomie (Miu Nakamura) who goes to the same high school.

Confused, Tsukiko stops taking pictures and watches in horror as Tomie is crushed on her neck by a steel cross that falls from a building under construction, killing her.

One year later, Tsukiko's daily life slowly returns to some sense of normality, but she still suffers from grief and recurring nightmares over her stepsister's death.

When Tsukiko goes to get the door, she sees that it is her deceased sister; Tomie stands in the doorway with her beauty shining even more brightly than before.

Tomie manages to get Masashi to whip Tsukiko across the back with a steam iron cable as punishment for not showing affection towards her.

However, Tomie's behavior starts becoming increasingly bizarre and abnormal as she shows Tsukiko the scar on her neck that begins to evolve into a deranged, talking tumor.

Meanwhile, at home, Tomie's head rises from the trash bin and convinces her father to kill his wife and feed her body to her.

Tsukiko sighs in relief, believing she just had a bad nightmare which proves to be false when Masashi starts eating hair and Kimiko’s head suddenly stretches abnormally to the point where it appears to be upside down.

Tsukiko runs upstairs and encounters Toshio and Yoshie, who tell her that they are mortified by their friendship with her in her dream, and in real life, they always hated her and thought she was annoying.