The game features verbal interjections from the gameshow host such as "Total Carnage! I love it!" This quote gives itself to the title of the 1991 follow-up, Total Carnage, which, while not a direct sequel, features similar gameplay.
Along the way, Captain Carnage and Major Mayhem fight various mutants and monsters and eventually General Ahkboob himself. Ahkboob transforms into several forms, including a series of three giant heads.