What might Friedrich Nietzsche have to do with a 1924 silent film, even one that might be considered an exemplary representation of German Expressionism? Nietzsche wrote extensively about art and drama, of course, but his life was cut short at the beginning of the new century when moving pictures were only in gestation. I would like to suggest that there are currents in Nietzsche's thought that may be connected to Expressionism in general, and in particular to Robert Wiene's grotesque film, The Hands of Orlac (Orlac's Hände). It is not my intention to suggest direct linkage connecting Orlac, Nietzsche, and classical art. What I attempt to explore is Nietzsche's reading of classical tragedy as it relates to the spirit and tensions growing out of the binary distinction between the Apollonian and the Dionysian (intimately intertwined), and the ways in which Nietzsche's theoretical impulses may relate to German Expressionism. This chapter is not intended as a source study; rather, it seeks to serve as a speculative inquiry into fragments of Nietzschean gesture, sensibility, and sensitivity as they relate to a powerful and seductive film that I consider a fertile synecdoche of global Expressionism. Paul Orlac is an existential figure expressing Apollonian and Dionysian antipodes within himself, but he also lives the life of his times, as he must, in which these dialectical tensions born in antiquity find release in mid-1920s German culture, thus nurturing the festering impulses deep inside, and not only within the individual but also very much within the fabric of emerging Modernist culture.