Twisted Squirm appears on the ceilings. Getting too close to him will cause him to reach down and grab the player. Clicking side to side quickly enough will let the player go, otherwise, Twisted Squirm damages them. After Twisted Squirm grabs a player, he traverses to a different area. Twisted Squirm is similar to his Squirm Render Toon counterpart, but with a few major changes. Twisted Squirm's general color palette has been desaturated. He resides in a light green broken cocoon, which is covered and filled with Ichor. It hangs from the ceiling using the same substance. His arms have been replaced with Ichor claws, and his antennae have elongated, with Ichor on the tips. Twisted Squirm features the typical red sclerae, black irises, and red pupils that the other Twisteds have. He also appears to be in a perpetual state of sadness, with a watery look to his eyes, and a regretful face should he succeed in attacking a Toon. Twisted Squirm's eyes glow red in Blackouts, making him easier to locate.

Squirm is a bookworm-like Toon with six body segments, those of which go in a repeating coloration order of blue and mint, being the same colors as their antennae, in that order. The third, fourth, and fifth segments of his body has a pair of limbs, those being a greenish-yellowish color, the same as the heart shape in his face. On his face, he have three dark green freckles on his cheeks and droopy eyes.

Squirm is shy, he likes to eat bookals and he is a BOOKWORM. don't mistake him for a caterpillar