The place where nightmares become real and the closest most people will get to Hell without Falling, the Otherworld is a forsaken realm where the bizarre and macabre take hold and don't let go until the blessed air raid siren wails. It is regarded as the Holy Land by Xuchilbara and Valtiel, where the Valves and the Body Pit are kept.
The Otherworld is generally a magnified version of the Fog World, where it it is depicted as a rusted, ruined dimension. Much of it is composed entirely of rusty brown metal floors and walls, which are often bloodstained as well. Grating, fencing, barbed wires, or entire sections of wall made from flesh and other organic material are also common. Elements like chains, hooks, industrial fans, cages and corpses are also very common. It follows the Fog World in the bizarre and macabre, comforming to the person's deepest secrets and inner demons.