The strained smile that Goth holds for more than three minutes behind the closing credits was a spur-of-the-moment inspiration from Ti West. He had planned to film her smiling and then choose a freeze-frame of the most unsettling shot, but at the last minute suggested "What if you hold a smile as long as you possibly can and let's see what happens?" They shot the smile, which "goes from comical to haunting to deeply disturbing the longer it continues," in one take.
After the final "Pearl" title card, what appears to be a VHS tape starts playing a 1-minute teaser trailer for MaXXXine, the third film in Ti West's X trilogy, once again starring Mia Goth as Maxine in 1985 Los Angeles.
For the last minute and a half, Pearl's name can be heard repeated in a loud whisper, with the last whisper especially pronounced and lengthened.
After the tile is shown one last time, during the copyright, the film resembles a film reel running out of its projector, with scratches and spots on the image and the image rapidly diminishing. This is difficult to see unless paying the film at slow speed.