Because of its extreme content, many mainstream streaming services like Netflix or Disney+ refuse to host the film.

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The cinematography in The Human Centipede 2 Lk21 is noteworthy for its stark and unflinching portrayal of the horrors that unfold on screen. The film's use of close-ups, medium shots, and long takes creates a sense of intimacy and immediacy, drawing the audience into the world of the film and making them complicit in the horrors that unfold.

Directed by Tom Six, the second installment of the Human Centipede trilogy takes a "meta" approach. Unlike the first film, which was a clinical, colorful horror thriller, the sequel is shot in grainy, high-contrast black and white.