WITH BRUTAL INEFFICIENCY, it begins. David Cronenberg's latest opens with a straight razor clumsily sawing through a windpipe, releasing a spurting fountain of bright blood; moments later, heavy crimson drops splatter onto linoleum tile, falling from beneath a 14-year-old girl's dress right before she collapses in a London pharmacy.

On the surface level, it's the violence, or the threat of it, that's most memorable in Cronenberg's work—Jeff Goldblum carefully adding discarded body parts to his bathroom cabinet in The Fly; Jeremy Irons and Jeremy Irons' platter of startling surgical instruments in Dead Ringers; Ed Harris' face disintegrating behind the fiery burst of a gunshot in A History of Violence; that smashed pumpkin of an exploding head in Scanners. Imagery wise, it's hard to top the animal reaction that Cronenberg inspires as he dismembers and twists flesh for the camera—so much so, in fact, that it's sometimes easy to forget the emotional and psychological violence he commits is what gives his images such power.

And there's plenty of that latter sort of violence in Eastern Promises. Plot wise, it's a bit clunky: Anna (Naomi Watts) works in a London hospital, and when the aforementioned 14-year-old gives birth and promptly dies, Anna takes a keen interest in looking out for the newborn. Clutching the deceased mother's diary—written in Russian—the unbelievably naïve Anna soon finds herself ass-deep in London's Russian mafia, largely dealing with the sinister, fascinating Nikolai (Viggo Mortensen). Ostensibly, Nikolai's just the driver for a Russian mobster, but we soon discover that he's also an "undertaker"—stubbing out a lit cigarette on his tongue, Nikolai stoically advises an onlooker that he might want to leave the room, and then he begins to prepare a body to be dumped in the Thames, yanking its teeth and cutting off its fingertips.

Given these seedy, lurid elements, Steven Knight's (Dirty Pretty Things) noirish script doesn't gel quite as well as it should, especially as things head into the final reel. But as a framework for its characters and Cronenberg's psychologically intense explorations, Eastern Promises' script is perfectly serviceable. While Anna's character is a bit of a letdown—she's an ill-advised woman whose chief trait is an overly simplified maternal instinct—Knight more than makes up for Anna with Nikolai. As performed by Mortensen, Nikolai's taut intensity and veiled motives make his heavily accented character a vicious, barely contained force; covered in menacing tattoos and brooding harder than a teenager waiting for his ride home from a Skinny Puppy show, Mortensen gives every scene he's in a vibrant, ominous edge.

Which isn't to say that Cronenberg is slacking. Throughout, Eastern Promises' tone and look is one of reserved menace lurking just beneath an oblivious city, with Cronenberg's vision of crime and the people guilty of it fresh enough to enthrall and authentic enough to terrify. Likewise, Cronenberg can still surprise: Eastern Promises' most memorable chunk is a squirming, desperate fight scene in a murky bathhouse. Gasp-inducing in its cruelty and veracity, it's also oddly, creepily hilarious and surreal. The audience I saw it with spent the scene wincing and gasping, alternately—impressed with Cronenberg's still-powerful ability to elicit a gut reaction, sure, but emotionally engaged enough to make all the blood matter.