Something that is so vile and disgusting that any other word can not describe it. Just saying "gross" is not enough when something is grotesque. An example of something that is grotesque would be scat porn with midgets and fat people. Or a violently deformed animal that drools and has visibly obvious diseases. When you see something that is so repulsive that you can't think of a word to describe it, the word 'grotesque' is appropriate.
The morbidly obese woman pulled down her panties and sharted liquid feces all over the supermarket floor in a grotesque display of horror.
The horse had a missing leg, mangled face and tumors bulging all over it's grotesque body.
While the man waited in line at the bank, his eyeball suddenly fell out of its socket and green liquid oozed down his face to make him a grotesque display of eye-failure.
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