The central twist of "Perfect Blue" is the revelation that Mima's manager, Rumi Hidaka, is the true antagonist. Rumi, a failed pop idol from a previous generation, suffers from Dissociative Identity Disorder (DID) and has developed a persona that believes it is the 'real' Mima—specifically, the pure, innocent pop idol Mima used to be. Mima's decision to become an actress and shed her idol image triggers a violent psychological break in Rumi.
It was Rumi who created the website "Mima's Room," using her intimate access as Mima's manager to post diary entries that would gaslight Mima into questioning her own sanity. Rumi also manipulated the obsessive stalker, Me-Mania, by sending him emails posing as the 'Idol Mima,' inciting him to act as her enforcer to punish those 'tarnishing' Mima's image. Rumi herself is responsible for several of the murders, including killing the photographer, the scriptwriter, and eventually Me-Mania after his failed attempt to assault Mima.
The climax reveals this truth when Rumi, dressed in a replica of Mima's idol costume, confronts Mima in a perfect recreation of her bedroom that Rumi had built in her own apartment. The ensuing chase through the city is not between Mima and her hallucination, but between Mima and the dangerously unhinged Rumi. Mima survives after pushing Rumi in front of an oncoming truck to save her from being run over, which leads to Rumi's institutionalization. The final scene confirms Mima has recovered from her trauma, while Rumi remains trapped in her delusion, forever believing she is the pop idol Mima. All the moments where Mima suspected she might be the killer were the result of Rumi's elaborate and cruel manipulation combined with Mima's own stress-induced psychosis.