Killed by Death blatantly 'borrows' from Wes Craven's 1984 horror classic A Nightmare on Elm Street for its ideas, and even some of its imagery. Moving Buffy into the hospital diminishes the group dynamic that energises most episodes, and seems to merely be an excuse to use young children as the prey of a supernatural serial killer.

Genuine highlights are few and far between, but pairing up Giles and Cordelia provides much-needed humour in an otherwise gloomy episode ("Boy, there's a demon for everything!"), and the tension between Xander and Angel when they meet at the hospital is rather satisfying ("It must just eat you up that I got there first").

Established character actor Richard Herd (the alien leader in V) has a throwaway role, and barely any dialogue, as Doctor Stanley Backer; Buffy's fight with the Kindestod is poorly directed, and perhaps needs a couple of clumsily-added lines of dialogue to explain what happened; and the last scene seems so superfluous it draws undue attention to itself. It's all a bit of a mess really...