It's been quite some time since I've seen this, probably somewhere around five or six years. From what I recall, I liked it, and upon seeing it again, I think it, by-and-large, holds up.
Based off a short story written by Clive Barker, the plot is decently interesting and captivating. Bradley Cooper made for a solid main character, and both Vinnie Jones and Roger Bart (who I recognized, after a few scenes, from Hostel: Part II), not to mention Leslie Bibb, made good secondary characters. The lore behind the going-ons was interesting also, though I hear that the original story went a little more in depth.
The special effects were mostly solid, and the heavy gore welcome. Some really brutal killings where in this film, and they were quite enjoyable. The epic fight at the end, too, was pretty fun. But it's in this realm where my main issues with the movie come from, being the use of CGI more than a few times. Some of the killings just looked rather blah due to the CGI use, and while it's always nice to see more gore, when it's tainted with CGI, it sticks out pretty noticeably.
Other than that, though, I think the movie's pretty good. The ending is generally pretty fun, and while at times I do think the pacing could have been tightened up, The Midnight Meat Train is a more-modern film that I think many horror fans would get a kick out of.