The Descent (2005)
Directed by Neil Marshall, the Descent eschews the normal horror movie cheese and silliness for real tension and suspense. The story is pretty simple, a group of women who have been friends for years go on a caving expedition to help one of the members recover from the death of her husband and daughter and along the way get lost in the cave and mostly eaten by blind subterranean albino cannibals. Of all the movies at the Scream-o-rama this one was the best in terms of just actually being a good movie. There is a lot of good character development and intrigue here and the feeling of claustrophobia really amps up the suspense and the creeping sense of dread.
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