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In this paper, the authors explore the depiction of perversion and the associated interplay of life and death drives in Roman Polanski’s 1992 film Bitter Moon. To begin with, a theoretical discussion is presented regarding perverse organizations of mastery and sadomasochism. Perversion is viewed as an expression of the death drive under erotic disguise, in which the destructive fingerprint of the death drive is revealed at every stage, having as its ultimate purpose the destruction of the other. Based on these theoretical insights a dialogue is developed with Polanski’s film, which brings to life the theory of sadomasochistic relations through the multidimensional aesthetic medium of cinema. It is shown how Polanski’s cinematic oeuvre conveys the essence of the difficult and complex experience of perverse relations, where the life and death drives and their transformations are manifested. The portrayal of the sadomasochistic relations in this film contributes to the experiential knowledge with which the authors promote insight that would potentially enrich the clinical work with patients with perverse organizations.