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Sam Levy's poetry is centered around the theme of identity, questioning not just who we are but what we are as humans. She tends to explore psychological and conceptual ideas about the nature of existence and reality.

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Sam's speculative cosmic horror fiction is heavily influenced by folklore, magic, and mysticism. Unnerving and haunting in its effect, her writing draws from the world of the uncanny, where the impossible could be possible, or the inexplicable can be explained, or events could be the product of a character’s mind. Sam's work explores themes such as perception, insanity, and our place in the cosmos. Tapping into mythology and archetypes, her work seeks to play with deception and bend reality, demonstrating that the world is a much more mysterious place than it seems.