The prison scenes were filmed in order, with only Sam Heughan and Tobias Menzies on set. Both cast and crew described the shoot as 'exhausting', emotionally draining, and 'very hard to watch'.
The ship Christabel was a functioning tall ship that was sailed from England to the coast of Scotland for production. The final shot of Claire and Jamie standing on the ship's deck is real and was captured from a helicopter.
The scene in which Jamie lies across Randall's lap in a pose which resembles a Pieta was improvised by the actors. The director was so struck by the image that Randall's line about Jamie suffering like Christ was added to the scene.
At least three versions of Jamie's injured hand were used during filming. One was an animatronic hand for the table scene, with fingers that twitched, one was the hand on which Claire performs surgery, and one was Heughan's real hand covered in blood and prosthetic make-up.
The abbey scenes were filmed at Aberdour Castle in Fife.