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Big Red is a monster found in the sewers. It is said by some to be one of the scariest parts of the game, as it is encountered right after the sewers, which is infamous for its eerie settings and creatures. Madotsuki is eaten by Big Red to proceed to the Windmill World.
Something notable is how Big Red slightly resembles Dave Spector, a creature in Monochrome world that has similar eyes to Big Red.
Trivia
"Big Red" is a nickname for Satan.