Tabitha and her two friends are captured by a killer with a deranged laugh. He kills her two friends. Tabitha survives after killing him. At the end you discover that he was a boy the girls grew up with. Because they made fun of him as a child he decided to get his revenge when they were older and kill them.
Rob and Shelby are on the highway headed to Cincinnati. On the way there they join a convoy of vehicles. The convoy decides to pull over for gas. Rob meets the drivers of the 2 other vehicles in the convoy. The driver of the semi tells them that the highway ahead has bad traffic and he can show them an alternate route. At the gas station Shelby sees a woman in the window of the semi who looks scared. After they are on the road again she sees the same girl put a "Help Me" sign in the back window of the semi. The girl eventually jumps from the semi and lands on their car. The 2 cars stop and the driver of the Jeep along with Rob and Shelby get out to help the girl. The semi keeps on driving. Rob gets back in his car and chases the semi to get his plates. The driver ends up cornering Rob and then taking off back down the hill. When Rob gets back to where the others are the driver of the Jeep says that the semi driver took Shelby and the original girl from the truck. They get in the guy's Jeep and chase down the semi to an old house. The driver of the Jeep says he wants to go first (to try and stop the semi driver). Rob waits in the Jeep. Suddenly he hears a noise. He finds a cb-radio in the center console. Then he hears more noise. He looks in the back and sees movement under a tarp. He moves the tarp and sees both girls tied up. Suddenly the driver of the Jeep comes back (after bashing in the skull of the semi driver). He breaks the window of the Jeep to attack Rob.
Next scene is of a girl named Tabitha who is babysitting for her aunt. After putting the boys to bed she goes to the guest bedroom. She notices a life size clown doll. She doesn't pay much attention to it. Then she gets a call from her aunt and mentions that she's a bit spooked by the doll. The Aunt says that they dont have a life size doll. Thats when she notices the doll isn't in the chair anymore. She runs to the boys room to get them out of the house. The doll shoves spikes through the door. She and the kids get out of the house. The clown finds Shelby in the shed outside.
Next scene you see Tabitha in a police interrogation room. A therapist comes in to talk to her. She asks her about her friend Lisa. Tabitha then starts having flashbacks. She flashes back to memories of her 2 friends Shelby and Lisa when they were all kids. A boy they were friends with shows them scary art he has created. Then it flashes to the present. Lisa is with her boyfriend looking for her roommate Cat who has suddenly disappeared.
They go to an old hotel that Lisa might be at. When she has no luck with the guy who answers the door Lisa sends her boyfriend inside. The guy who answers the door is the killer and he kills the boyfriend. A few hours later, worried about her boyfriend, Lisa goes inside and finds dead bodies all over the place. Then she comes face to face with the killer.
Again at the police station Tabitha is being grilled by the therapist. The woman asks Tabitha about her friend Shelby. Tabitha says that they were all friends. The therapist then tells her about a boy she had as a patient. Before she walks out she tells Tabitha that Lisa and Shelby are at the station, too, and to sit tight because she will be back for them. The door suddenly opens. When Tabitha walks outside the room she realizes that she is not at the police station afterall. At the end of the hallway she sees the therapist on the floor. She approaches the body when she sees an officer approaching, too. That's when she sees that he's not a cop, he's really the killer. He chases her around the basement. Eventually she's pinned in between 2 glass walls. When the lights come on behind the glass walls she sees Lisa and Shelby chained up. Eventually she's able to help them break free.
They try to make a run for it together. Before they get far the killer stabs Lisa. Tabitha and Shelby run for it. They begin climbing a ladder as the killer chases them. He climbs up behind them and grabs a hold of Shelby. Both he and Shelby fall back down to the basement floor. Tabitha continues to climb. Once at ground level she sees she's in a caged area. Suddenly an elevator comes on and she realizes the killer is coming up. She hides in what she thinks is a closet. The killer looks through a peep hole at her and then locks her in the room. Suddenly the room starts to move and she realizes she's in the back of a truck. The truck doesn't make it far from the house (which is the same house from the beginning of the movie). Tabitha grabs one of the spiked handles that the killer had used in the house she was babysitting in. When he looks through the peep hole again she stabs him in the eye. Then you see the truck driving away and hear Tabitha's voice talking about how she and her friends had laughed at him when they were a kid. And she says that even though it's all over she still can't get his
voice out of her head.