According to Sean S. Cunningham, the film was going to be named 'House III', but the new distributor, MGM, wanted a fresh start with potential new series with a new iconic villain, so the script was modified to reflect the new approach, and it was re-titled "The Horror Show" for the US theatrical release, while the title "House III" was maintained for the non-US market.
Brion James (Max Jenke) has said in several interviews that of all the roles he's played, this is his favorite.
Was one three films in 1989/1990 that had a story line involving an executed serial killer coming back to life and stalking people. The other two films were Shocker (1989) and The First Power (1990).
The film was heavily cut for an R rating. Some scenes were cut down while other scenes were removed completely to avoid getting an X rating by the MPAA. Although the European cut features extra gore and violence, the fully uncut version was never released. Some stills show scenes which were deleted and not included in any version of the movie: Bonnie's birthday scene where blood spills out of her birthday cake, a scene showing Bonnie's dead boyfriend being torn in half, and a scene where Lucas pulls his chest open and then his heart is shown.