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Plot
Six days after Rose Cotter's death,[a] the now-cursed police officer Joel attempts to pass the Smile Entity on by killing one murderous criminal in front of another. During a shootout, he accidentally kills the second. Uninvolved drug dealer Lewis Fregoli witnesses this and inherits the curse. Joel, now free from the curse, attempts to flee but is run over and killed by a truck.
Meanwhile, pop star Skye Riley appears on The Drew Barrymore Show as she prepares for her comeback tour following a public struggle with substance abuse and a car crash that killed her actor boyfriend, Paul Hudson, a year earlier. Despite constant supervision from her assistant Joshua and mother and manager Elizabeth, Skye sneaks out to buy Vicodin from Lewis, her former schoolmate, after injuring her back in rehearsals. Lewis appears erratic, screaming and panicking before collapsing in an apparent seizure. He rises, smiling, and fatally smashes his face in with a barbell plate. Afraid of being found in a room full of drugs and alcohol, Skye flees without alerting anyone.
Skye begins to experience hallucinations, including people smiling at her, causing her mental health to deteriorate rapidly. Needing support, she reconciles with her estranged friend Gemma. Skye receives a text from an unknown number, claiming to know she was at Lewis's apartment and that she is in danger. While speaking at a fundraiser hosted by music executive Darius, Skye hallucinates the teleprompter stalling and goes on an impromptu tirade about how success has not fixed her life. She sees a smiling Paul approaching from the audience and panics, accidentally injuring an elderly guest.
Skye meets Morris, the man who texted her, in a bar. He has been tracking the Entity ever since it killed his brother. He explains that the curse passes to anyone who witnesses a victim's death. Theorizing that the Entity is parasitic and could die without a host, he suggests stopping Skye's heart and then resuscitating her to break the curse, but she refuses and leaves after being recognized. Following a lengthy mental breakdown in her apartment, Skye is cornered by the Entity, which takes the form of her backup dancers. Skye tries to flee but is violently thrown around the apartment and pinned down as a giant arm forces its way into her throat, causing her to blackout.
A flashback reveals Skye caused Paul's death by intentionally crashing the car during a drug-induced argument. Later, Skye awakes at a retreat and argues with Elizabeth over the upcoming tour. Suddenly, Elizabeth smiles, smashes a mirror, and stabs herself with a shard. Skye attempts to leave but, to her horror, realizes that it was in fact she who stabbed Elizabeth. Skye escapes the retreat and reunites with Gemma, stealing a car to meet Morris. Skye receives a call from Gemma, and realizes that the Gemma who has been with her all week is the Entity. After regaining control of the car, Skye meets Morris at an abandoned Pizza Hut, where they plan to use the walk-in freezer to prevent brain damage when stopping her heart. Morris temporarily leaves and the Entity appears as Skye's former self from the car wreck. After a struggle, Skye fights it off and injects herself with the syringe meant to stop her heart. The Entity, unchanged, mockingly affirms she is not in control. It then locks Skye into a rib-cage apparatus and tells her to "break a leg".
Skye finds herself on stage for a performance at Herald Square Garden.[b] She sees a still-alive Elizabeth, Joshua and Darius watching from the audience, and realizes that the entirety of the past couple of days have been a hallucination. The Entity appears as Skye's current self before tearing its stomach open to reveal its true form: a large, skinless creature with multiple smiling mouths nestled within one another. Skye screams before falling into a trance, and the Entity rips Skye's mouth apart and crawls inside; to the crowd, it just appears that Skye collapses while choking. A possessed Skye stands up, now smiling as she fatally stabs herself in the eye with her microphone in front of thousands of horrified spectators.
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