Destroying other universes - Marvel Comics: Events called Incursions start occurring all over the multiverse, where two alternate versions of Earth violently collide and destroy both universes in their entirety. The only way to prevent an incursion is for one universe to destroy the Earth of the other universe, killing billions to save trillions. Unfortunately, it turns out even that only buys time, as even if a universe spares itself from the Incursions, the multiverse as a whole was still dying.
Allowing Canon Events - Spiderverse: Spider-men across the multiverse are united by the multiversal thread known as the Web of Life and Destiny. Part of this is that all Spider-men are destined to live very similar lives: All are bitten by a radioactive spider, all experience the death of an uncle/father figure that teaches them responsibility, all fail to save a police captain who they become close to, all that have relationships with a Gwen Stacy variant have that relationship end in tragedy. One job of the multiversal Spider-Society led by Miguel O'hara is to make sure canon events happen at any cost: Because according to him, any canon event being broken inevitably results in the destruction of that Spider-Man's universe. This means preventing the loved ones of countless Spider-Men from being saved, since them living would "break canon" and doom the universe.
Letting the villains win - Gameoverse: The Gameoverse is filled with countless planets that seem to function under video game rules, with a heroic player character that has to fight through many levels and beat an evil final boss. The twist is that once the final boss is beaten, the game is now over, resulting in the violent destruction of the now obsolete game world. The protagonists are a team of former player characters who survived the destruction of their own games, with goal of sabotaging heroes and aiding villains in other game worlds because helping the bad guy win is preferable to letting everything be destroyed.
Sacrificing teenagers to horror movie monsters - Cabin in the Woods: There are evil eldritch beings lying in wait to destroy our world. A secretive organization works to keep them contained with a special ritual, where 5 teenagers fitting classic horror movie archetypes must be hunted and killed by a supernatural slasher/monster. As long as all victims except the "Virgin"/Final Girl are killed, the eldritch beings are sated for one year, otherwise they destroy the world. Two of the protagonists survive their engineered horror scenario, and we see just how real the ritual was as a giant hand bursts from the ground and kills them both.
Procedure 110 Montauk - SCP Foundation (No image included because the article doesn't have any): 7 women are captured by a cult known as the "Children of the Scarlet King", and anomalously impregnated with the eldritch god's "children". Though the women are freed from the cult and recovered by the SCP Foundation, they begin giving birth one by one to increasingly powerful and dangerous monsters. Believing the seventh woman will give birth to a monster so powerful it would render humanity extinct, or perhaps even one that could bring the Scarlet King himself into reality, the Foundation resorts to using Procedure 110 Montauk to delay the birth for as long as possible. Though the details of what 110 Montauk entails are entirely censored to us, we do know that it is incredibly horrifying and torturous, the procedure NEEDS the suffering to function, and the people who carry out the procedure often choose to erase their own memories afterwards due to the guilt. However, there's simply no other way to prevent the birth of the Scarlet King's last child: No medical procedure or magical ritual can kill the fetus in the womb, and killing the mother just results in the child being born anyway. The worst part: Though the final mother's age is redacted, from the length of the redaction you can tell it's between a double digit and SINGLE digit number, meaning there's a very high chance this is all happening to a CHILD.