It is revealed that Pamela is in fact William's SISTER and is the family he was trying to save. The mother and son are the family of the man who died and William was facing legal action over. It is then revealed the true twist of the game - William had to make it there, with Pamela as the lure.

Similar to its predecessor, Saw VI maintains the focus on the posthumous effects of the Jigsaw Killer and the progression of his successor, Detective Hoffman. The plot follows an insurance executive who must complete a series of deadly "games" set up by Hoffman in order to rescue his employees.