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In 1954, two U.S. marshals Teddy Daniels (Leonardo DiCaprio) and Chuck Aule (Mark Ruffalo) investigate the disappearance of a patient from a hospital for the criminally insane on an island in Massachusetts. They run into trouble when they are deceived by the hospital's chief administrator Dr. John Cawley (Ben Kingsley), a hurricane hits, they uncover a series of sinister human experiments, reminiscent of Nazi human experimentation.[4]

In the end of the movie it is revealed that "Teddy" is actually a delusional mental patient in the hospital. He murdered his manic depressive wife Dolores Chanal (Michelle Williams) after she drowned their three children. He was a mental patient at the hospital for two years, and the doctors decided to try a roleplay experiment to allow him to live out his delusional fantasy in order to come to grips with reality. The treatment plan works - and the patient is retold what has happened to him and he accepts what he did to his wife. However, in the final scene he relapses to a delusional state, and the administrator decides to lobotomize him. It is implied that he is faking his relapse so he will not have to deal with the mental anguish of his act.

Feature film rights to the 2003 novel Shutter Island by Dennis Lehane were first optioned to Columbia Pictures in 2003, but the rights lapsed back to the author. The author's representatives then sold the rights to the production company Phoenix Pictures, who hired screenwriter Laeta Kalogridis to script the novel for a film adaptation. The project was in development for a year. By October 2007, the project had developed into a co-production between the studios Columbia Pictures and Paramount Pictures. Director Martin Scorsese and actor Leonardo DiCaprio, who had worked together on three films, were both attracted to Shutter Island as their next collaboration. Locations in Massachusetts, Connecticut, and Nova Scotia were scouted.[5] Production began on March 6, 2008.[4]

In order to film World War II flashback scenes of DiCaprio's character, a former soldier, production took place in Taunton, Massachusetts.[6] Scorsese filmed the scenes in old industrial buildings in Taunton's Whittenton Mills Complex to replicate Dachau, a World War II concentration camp seen in flashbacks.[7] Extras portraying the Dachau prisoners were called back to reshoot a scene in July, due to the film of one scene being damaged due to an improperly sealed film shipping container. Scenes were filmed at the old Medfield State Hospital in Medfield, Massachusetts. Originally, scenes were going to be shot at the old Worcester State Hospital, but the filming would have gone on during the demolition of the surrounding buildings, so filming was impractical. Peddocks Island was used as a setting for the story's island and East Point, in Nahant, Massachusetts for the lighthouse scenes.[8] Filming ended on July 2, 2008.[9]

No original soundtrack was written for the film. Instead, Scorsese made use of his long time collaborator Robbie Robertson to create an ensemble of previously recorded material to use in the film. According to a statement on Paramount's website: "The collection of modern classical music [on the soundtrack album] was hand-selected by Robertson, who is proud of its scope and sound. 'This may be the most outrageous and beautiful soundtrack I've ever heard.' [Robertson stated]."[10]

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