Domestic violence is not shown on screen, except maybe in the scene where the detectives are investigating the killer's apartment, are shot at, and chase the killer through an apartment building. However, Somerset talks about many domestic violence cases, and also overhears domestic commotion from his apartment.
One of the murder victims is given a sadistic “choice” - survive and be disfigured for life, or take sleeping pills to “put her out of her misery.” She chooses the latter
This movie portrays the aftermath of a wide variety of physical and psychological torture. The killer plays psychological games with his victims, often leading to agonizing deaths. One victim eats until his stomach literally bursts. Another is forced to cut “a pound of flesh” from his body. Yet another is kept barely alive in the same room for a year, until he becomes a gaunt living corpse who cannot think or speak
I don’t think anyone vomits, but there is a scene near the beginning where they are investigating a house, and one character sniffs a bucket that was underneath a table and says that there is vomit in there. Nothing inside it is shown.
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Mills wife is killed while she’s pregnant. She never looks pregnant or anything but it’s mentioned
There is a murder case based around Lust. There's also a photo shown of the custom strap-on that the killer made to kill the victim during intercourse.
The killer “wins,” having committed all the crimes he wanted to. Nobody will miss him, but the detectives failed to stop anything. Due to the brutal nature of the murders, Morgan Freeman partially loses faith in humanity. Brad Pitt loses his wife, his unborn child and his sanity.
Blood and gore are a constant in this movie. There are frequently graphic images of murder victims in various states of mutilation and decomposition. The horrifically violent matter of their deaths is described in detail.