I don't know much about theatre in Japan, but I associate this movie to be similar to the the little Noh I have seen, even though the stage play in center of the narrative is based on the play "Yotsuya Kaidan" from the later period of Kabuki theatre.

Kuime takes you on a mesmerizing journey of two, if not three or more, parallel narratives where the on stage facilitates the backstage drama. The pacing is very restrained and timing for accents is crucial. Aesthetically it is very pleasing and has an interesting exposed re-use of the movie sets similar to the actors doing multiple roles and their stories being intertwined. Finally the horror elements are creeping and lead up to several gruesome conclusions.

That said, I can see why it did not attract a western audience, as the pacing may be too slow for a western horror audience and the multilayered narrative is more common in the festival circuit.

Personally I find that after the one and half hours of elegant theater, the twenty minutes or so finale was a bit crude and could have been worked through better. Still, I found myself very attentive throughout the movie, got affected by the horrific crescendos and maintained an interest for the artistic aspects as well. In conclusion, I'd consider it one of the better movies I have seen by Takashi Miike.