This vehicular combat game set in Hell revolves around the production of Earache Records, a British label that specialized in death metal and other genres of extreme music. Each selectable vehicle is themed after one of the bands that were on the Earache roster at the time of release, including Deicide, Morbid Angel and Municipal Waste. Every vehicle features a unique weapon, which may be projectile or melee. More tracks and vehicles are unlocked with points, which are accumulated by holding the pole position, eliminating opponents or running over pedestrians: these are zombies that wander aimlessly around the tracks, some of which also offer power-ups. The cars compete against each other in a variety of modes, such as multiple-lap race, deathmatch arena, league and "zombie massacre" - a mode where the car that runs over most zombies in the arena wins.
The track race, league and deathmatch modes are also playable in split-screen multiplayer. The game soundtrack features songs of all the bands represented in the game, as well as of bands from the past Earache roster such as Carcass or Cathedral.