If you’ve spent more than five minutes in the Dead by Daylight community, you know Sally Smithson—the Nurse—is the undisputed queen of the meta. She breaks the game's rules. She ignores walls. But for a lot of players, it isn't just her blink mechanic that’s intimidating; it’s the sheer variety of ways she can look while she’s hovering toward you at Mach 1. Among her most iconic and genuinely unsettling pieces of gear is the twisted saw weapon dbd nurse players have been rocking for years.
It’s gross. It’s jagged. It looks like it hasn't been cleaned since the Crotus Prenn Asylum was actually functional.
But here’s the thing: cosmetics in DBD aren't just about looking cool for the endgame screen. They carry a certain "vibe" that can actually change how survivors react to you. When you see a Nurse sporting the Twisted Saw, you aren't looking at a beginner who just downloaded the game. You're usually looking at someone who has put in the hundreds of hours required to master the muscle memory of her fatigue frames.
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What exactly is the Twisted Saw?
Let's get the technical stuff out of the way first. The Twisted Saw is a cosmetic weapon for The Nurse, specifically part of her "The Bad Seed" collection. In the lore of the game, Sally was a nurse who snapped, and her weapons reflect that medical-horror aesthetic. The bone saw is her default, but the Twisted Saw takes that concept and turns the "rust and tetanus" dial up to eleven.
It’s a brutal, serrated piece of metal that looks like it was bent out of shape by sheer force.
While some weapons in the game—like the Spirit’s katanas or the Oni’s kanabo—feel sleek and powerful, the Twisted Saw feels desperate and mean. It has this gnarled, uneven edge. Honestly, it looks like it would hurt significantly more than a clean blade. It’s that jaggedness that makes it a favorite for players who want to lean into the "disturbed medical professional" fantasy.
Why players choose the Twisted Saw over other Nurse weapons
You'd think a glowing weapon or a prestige blade would be the top choice. Usually, it is. But the twisted saw weapon dbd nurse mains use has stayed relevant for a very specific reason: visibility and intimidation.
Nurse is a first-person killer. Her weapon takes up a decent chunk of the right side of your screen. Some of her larger, more "theatrical" weapons can actually feel a bit clunky or distracting when you’re trying to line up a precise blink through a tiny gap in a jungle gym. The Twisted Saw is relatively slim compared to some of the heavier event items, giving you a clear field of view while still looking menacing.
Then there's the psychological factor.
Dead by Daylight is a game of information and psychology. If a survivor sees a Nurse with the default circular saw, they might think, "Okay, maybe this person is practicing." If they see a Nurse with a legacy weapon or the Twisted Saw, they immediately start playing differently. They start doubling back more. They become more erratic because they assume you know how to read their movements. It sounds silly, but the "cosmetic meta" is a real thing in high-rank lobbies.
The evolution of Nurse's aesthetic
When Dead by Daylight first launched back in 2016, the Nurse didn't have nearly as many options. She was a breath of fresh air—well, as fresh as a suffocating ghost can be—in a game that was mostly about "m1 killers" like Trapper and Wraith. Her design was simple.
As the game grew, the art team at Behaviour Interactive started experimenting with more "body horror" elements.
The Twisted Saw came out during a period where the devs were really leaning into the grime. They wanted the Nurse to look like she belonged in a Victorian-era nightmare. If you look closely at the model for the saw, you can see the pitting in the metal. It’s not just "red paint" for blood; it’s textured to look like dried gore and oxidation. It’s a far cry from some of the neon, colorful skins we see for characters like Trickster or Feng Min today.
Hitboxes and "pay to win" myths
Is the twisted saw weapon dbd nurse players love actually better for gameplay? No.
Let's clear that up right now. Behaviour is very strict about hitboxes. Whether you are using a rusted piece of scrap metal or a golden relic, the reach is exactly the same. However, perception is reality. Some players swear that shorter-looking weapons make them feel like they have to get closer, which actually improves their accuracy. Others feel like longer weapons help them time their lunges.
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The Twisted Saw sits in that "Goldilocks" zone. It's long enough to feel like you have reach, but the jagged shape helps you pinpoint the tip of the blade during the lunge animation.
How to get the most out of your Nurse "look"
If you’re going to run the Twisted Saw, you might as well commit to the bit. Most players pair it with the "Gas Mask" or the "Torn Wedding Veil." The goal is to look like a literal nightmare.
- Pairing with Prestige: The Twisted Saw actually looks incredible when paired with the P3 bloody head piece. The reds match the rust perfectly.
- The "Silent" Nurse: Some players believe that certain cosmetics are quieter or harder to see on dark maps like the MacMillan Estate or Backwater Swamp. While the saw doesn't affect your breathing or blink sounds, its duller color palette makes you slightly harder to spot in a dark corner than, say, a glowing weapon from a Rift.
Why we still talk about this weapon years later
It’s rare for a non-licensed, non-event cosmetic to stay popular for this long. Usually, players move on to the newest, shiniest thing. But the twisted saw weapon dbd nurse players have stuck with is a testament to the Nurse's core design. She’s a character rooted in tragedy and medical horror. A jagged, broken saw fits her better than a pristine blade ever could.
It reminds me of the early days of the game. Back when the fog was thicker and the game felt more like a horror movie than a competitive e-sport.
The Nurse is arguably the hardest character to learn in the game. You will lose. A lot. You will blink into basements you didn't mean to go into. You’ll overshoot survivors and spend half the match looking at the floor in fatigue. But when it finally clicks? When you start predicting movements and landing those surgical hits? Having a weapon like the Twisted Saw at the end of your arm just makes the victory feel a bit more thematic.
Actionable insights for aspiring Nurse mains
If you're looking to upgrade your Nurse's look or improve your gameplay, start by focusing on the fundamentals before worrying about the cosmetics. The Twisted Saw is a great aesthetic choice, but it won't help you if you can't manage your blink distance.
Practice your "muscle memory" by using the Plaid Flannel add-on for a few matches. It shows you exactly where you're going to land. Once you can feel that distance without the visual aid, take the flannel off. That's when you start becoming a threat.
Also, keep an eye on the store for bundles. Sometimes these older pieces go on sale for Iridescent Shards, meaning you can pick them up just by playing the game rather than spending real money (Auric Cells).
Check your current inventory for the following:
- Plaid Flannel: Essential for learning blink placement.
- Heavy Panting: Increases lunge duration after a blink, which pairs nicely with the visual feel of the Twisted Saw.
- Fragile Wheeze: Gives you more control over your chain blinks.
Mastering the Nurse is a marathon, not a sprint. The Twisted Saw is just the grizzly trophy you carry across the finish line.
Next steps for your DBD journey
To really lean into the Nurse meta, start recording your matches. Watching your blink placement in slow motion reveals more about your mistakes than playing ten more games ever will. Once you’ve nailed the timing, go ahead and grab that twisted saw weapon dbd nurse players fear—you'll have earned the right to look that scary.
Build a "loadout" that fits your playstyle. If you like tracking, run A Nurse’s Calling. If you want to end chases instantly, focus on Starstruck. The weapon is the finishing touch on a build that should be designed to keep survivors guessing from the first second they hear that screeching blink sound.