Clive Barker had developed elaborate back-stories for the Cenobites in the first film, though their origins were never explored. In this film, he wanted to make sure that, at the very least, the audience understood that the Cenobites were once human, and that their own vices lead to their becoming demons. This element was meant to underline the story of Frank (Oliver Smith) and Julia (Clare Higgins) and their corruption by lust, with the latter intended to become the ultimate villain of the series, but Pinhead proved much more popular with audiences, and thus became the center point in further sequels.
An in-depth subplot detailing the origins of Pinhead (Doug Bradley) was scripted but deleted in preproduction due to last minute budget cuts. All that remains of this subplot is the film's prologue showing Capt. Spencer opening the box and transforming into Pinhead. Pinhead/Capt. Spencer's backstory was later explored in Hellraiser III: Hell on Earth (1992).
The horn sound that is continually made by Leviathan is Morse code for "God".
Andrew Robinson refused to reprise his role as Larry Cotton, forcing hasty script rewrites. This partially accounts for the muddled story structure of the final film.
Oliver Smith who played skinless Frank in the original due to his skinny frame (allowing the body makeup to be realistic) reprised his role along with two extra roles as Browning-the mental patient with delusional parasitosis, and as the skinless figure Kirsty see's in the hospital who writes in blood "I Am In Hell Help Me".