Everything shown in this documentary is real.
Lots of pigs are shown to have disturbingly big wounds and diseases.
Some people are shown to perform violence against some pigs, such as hitting, kicking, slamming and torturing them in various ways.
Several dead or dying pigs are shown. Some pigs are even shown as decomposed corpses.
Several footages, particularly the slaughterhouse footages, are quite gory.
Several other animals are shown to suffer from various cruelty inflicted on them, such as baby chickens ground up alive, turkeys being punched and kicked, and cows dehorned and castrated.