One of the Noblet dolls on Max's shelves has a visible penis.

The phenomena of sex and getting pregnant is explained with cartoons in non graphic way.

There is some very brief cartoon nudity when Max is shown naked on a desert island. His genitals are seen entirely, but from a distance.

There is a reference to someone's "wife's new breasts"

Mary asks questions about sex and "Where do babies come from?" in her first letter's written to Max. She misspells "vagina" and spells it "vergina" and talks about how she knows "sexing" and asking if babies come from bottles or nuns or eggs

Max gives a few explanations about where babies come from and one involves prostitutes laying eggs. Max also mentions having worked in a condom factory.

There is implied sex between Mary and Damien after they are married.

There are some pictures displaying women's breasts in some areas of the film but not graphic as it is not very noticeable

A mime artist is crushed by a large AC machine, cracks are seen in the side walk and a pool of blood is seen around his head, but it is hard to identify as Max's scenes are black and white.

Len, Mary's neighbour had his legs bitten off by piranha in WW2. A piranha is seen with a severed leg in its mouth and blood is spraying out of the wound, not very graphic but done in a comedic way.

Some mild cursing in the narrative, but nothing that most kids don't already know, and most parents are likely to find tolerable.

Inside the train Max usually rides with there are two '"f" words written on the walls but it's hard to notice.

Mary's mother is shown drinking and smoking in most of her scenes.

It eventually begins to get very dark and sad.

Mary imagines Max dead and being eaten by his pets: there is a brief but grotesque shot of this.

Scenes involving the death of some of Max's pets may disturb very young children (seeing his pet goldfish floating in its bowl, then scooped-up and flushed down the toilet).

Scenes with Max talking about his illness (Asperger's), being in a mental health unit / psychiactric unit may also be too dark for some children to grasp the fundamentals of. Max is a pitiful human being, but he has issues that he discusses and pokes fun at, in order to cope with his life and lack of friends. Sometimes this includes scenes of him talking about death, talking to non-existant friends, and dreaming of alternate realities in which he is loved and accepted like other, "normal" people. The tone can be quite dark and brooding at times, even when a scene involves a lot of comedy.