ABSTRACT Itō Junji has been a renowned horror author since his work Tomie was released in the late 1980s. Tomie tells the story of an eponymous vengeful entity who, after being killed by her classmates on a school trip, leads men she encounters to madness and to her assassination which leads to her multiplying and being reborn again. Previous studies have focused on gender-based readings of the violence and body-horror elements in Tomie, yet little attention has been given to how this latter works in tandem with other elements as affective devices. By drawing upon several concepts related to affect, this paper analyzes the use of horror manga to evoke affective and somatic responses in readers. It shows that the manga’s use of panelling and composition techniques associated with cinema plays an essential role in the creation of dread and anticipation. Additionally, the exploration of abjection and body horror reveals how these contribute to the reader’s responses which oscillate between sympathy and somatic empathy. Ultimately, this study highlights how horror manga, as a visual medium with cinematic traits, can elicit responses in readers similar to horror cinema and offers a potential theoretical framework for the broader study of horror manga.