Le Totentanz De Cauchemar is a symphonic poem and piano concerto in C-Sharp Minor. It is composed of three movements: An Andante, a Presto, and a second Andante.

The concerto is a orchestral telling of the poem Le Grand Jeu De Cauchemar, in which a woeful village of peasants is haunted by the horrifying monster Cauchemar, who takes those who are not vigilant of his coming in their sleep.

The first movement starts with the perspective of Cauchemar, who looks down to the village in the night from the cliff of his hill, waiting for the midnight hour to prepare for his raid of the lives of the acedious. The first seventeen notes symbolize the funereal bells of Death, whom Cauchemar is well acquainted with. The piece then transitions to a dramatic cord on piano, followed by a D#, E, and D#, which will see much repetition and variation through the piece, as it is the signature of Cauchemar: his Totentanz. After this, there is a rolling progression of notes across 8ths that rise up about half the piano, before the chord returns and the bells are introduced, along with timpani and organ. This part is to show Cauchemar, watching and waiting, and gives a sense of how fearsome he is.

The first movement is mostly contrapunctural, minimally using a viola de gamba and an ensemble of legato violins along with the stated instruments, a slowly building prelude that starts with piano and slowly involves the tubular bells (used as if a carillion), and high and low hand bells (the lower bells being what are known as death bells, the bells in times of antiquity rang for the dead and doomed). The main chord of the Totentanz is rarely broken, but rather continuously paraphrased, save for a few parts where the piano strays and the ringing of the bells warning of Cauchemar's coming. The first movement is in C-Sharp Minor and is in 3/4 time.

The second movement starts with a flurry of notes, paraphrasing the Dies Iræ (which is the theme of this movement), and is symbolic of Cauchemar charging down the hill at the sight of the peasant's revolt, before a set of notes sets a slower pace, symbolizing Cauchemar slowly approaching the defiant villagers. At this point, the piano plays a paraphrase of the first stanza of the Dies Iræ, followed by all the instruments playing the paraphrase again. At this point, the rest of the Dies Iræ (save for the second and third stanza) are played in a small fugue on piano, lasting the length of a slow playing on organ of the paraphrase of the second stanza of the Dies Iræ. The fugue, normally in only a bass, alto, and soprano part, gains a second alto part to state the last six lines of the Dies Iræ in together with the second and third to last stanzas. After this, the fugue is repeated, with other instruments copying it and varying it, as the organ plays the third stanza of the Dies Iræ. This use of the Dies Iræ demonstrates the wrath Cauchemar holds within, and the extraordinary carnage he will bring to the peasants for their outright defiance. The second movement is in 12/8 time, and is in F Major.

The final movement combines the two, swapping the D#-E-D# from the first movement with a paraphrase of the second movement Dies Iræ. This combination of the Totentanz with the Dies Iræ portrays Cauchemar's approach to the people, playing the first movement in this varied form to completion, where a few dramatic bars at the end spell the same end as the story: Cauchemar is running towards the villagers, but we are never to know their fates. The final movement is in C-Sharp Minor and is in 4/4 time.