Of course it's gruesome. This is easily the most convoluted series of films going, in or out of the horror movie ghetto. Not only do you have to know what's gone on in parts 1-4 to make much sense of the plot here, the film internally leaps around from past to present with little warning of impending changes. A dead guy in one scene is alive in the next. You've moved into a flashback, but you have to figure that out for yourself.
Picking up where "Saw IV" left off, the Jigsaw Killer's new accomplice continues facing people with horrendous traps, forcing them to make impossible choices. The movie is not just a sadistic stroll through the suburbs of hell. There is a plot. This one is directed by first-timer David Hackl, who doesn't do anything new, but doesn't screw up anything old. I'm still enjoying the double layer of suspense in these movies and I left "Saw V" feeling nicely flummoxed. If you can stand the gore, I bet you will, too.