Pusher II (also known as Pusher II: With Blood on My Hands) is a 2004 Danish crime film written and directed by Nicolas Winding Refn. It is the second film in the Pusher trilogy, portraying the lives of criminals in Copenhagen.

Before he is released from prison, Tonny hears a monologue by his cellmate advising him to conquer his fear. He reminds Tonny of a monetary debt he owes but chooses to give him a way out, of respect for his father, a vicious gangster known as the Duke. Upon his release, Tonny visits his father's garage business seeking employment. The Duke has a younger son from a different mother now and receives Tonny coldly, but he ultimately allows Tonny to work for him on a trial basis. Tonny steals a Ferrari in an effort to impress his father, but the car is rejected and the Duke berates Tonny for his irresponsibility.

While hanging out with his friend Ø, Tonny is told that he has a child with a local woman named Charlotte. Charlotte, who has been raising the child by herself, demands that Tonny start paying her child support. Tonny makes empty promises to pay, but soon comes to care for the child. He successfully participates in a car heist for the Duke, but is forced to ride in the trunk of the getaway car because there are no seats left.

Tonny helps a local pimp, Kurt the Cunt, make a heroin deal with Milo, a Serbian drug lord. When one of Milo's thugs arrives late, a spooked Kurt flushes the heroin down the toilet. Kurt now has no money or drugs to sell and cannot pay back the money he borrowed for the deal. He convinces Tonny to help buy him a gun and shoot him in the arm to convince Kurt's financial backer that he was robbed. While visiting with Charlotte and his son, Tonny learns how to change his son's diaper. Ø watches and reveals that he is about to marry his girlfriend Gry and have a child of his own.

At Ø's wedding reception, the Duke delivers a toast telling Ø that he thinks of him as a son, then chides Tonny. Tonny gets drunk and becomes angry as he watches Charlotte neglecting their child to snort cocaine with Gry in the club's kitchen. Tonny insists that she take the baby home, but she refuses by berating and humiliating him. Enraged, Tonny chokes Charlotte before several men pull him away. Realizing that he has once again made a fool of himself, Tonny leaves the party and meets Kurt, who is lingering outside.

Kurt convinces Tonny to help him smash up his apartment to further support their cover story. In return, Kurt promises to put in a good word for Tonny with the Duke. After Kurt attacks a prostitute that emerges from his bedroom, he tells Tonny he is going to finish her off and Tonny, wanting no part of it, leaves. Kurt reveals that his backer is the Duke and that he has lied so that Tonny will share in Kurt's debt.

Tonny visits his father to find a way to reconcile and pay off the debt. He volunteers to intimidate the Duke's ex-wife Jeanette, who is trying to take custody of his half-brother. The Duke is hesitant, but Tonny's uncle Red vouches for him because he did well during the car heist. The Duke insists that Tonny kill Jeanette, and he agrees. Tonny visits Jeanette at her workplace, Kurt's brothel, but cannot go through with the murder. After returning and admitting his failure to his father, the Duke berates him savagely. Tonny snaps and viciously stabs him to death. He flees and goes looking for Ø, but instead finds Gry and Charlotte getting high. They deride Tonny and leave the baby unattended. Tonny takes the child and gets on a bus, fleeing the city.

The film holds a score of 100% on Rotten Tomatoes, with an average rating of 7.7/10 based on 11 reviews from critics. Metacritic, which uses a weighted average, assigned the film a score of 78 out of 100, based on 8 critics, indicating "generally favorable" reviews.