The story takes place in 1991 and follows rookie agent G and detective Isaac Washington, who investigate a series of disappearances in Bayou City, Louisiana. They soon discover that behind it all is Papa Caesar, a twisted criminal causing an epidemic of mutations. The two protagonists face hordes of zombies and mutated creatures, while dark secrets about the source of the infection and the involvement of the Clement family are revealed.

The game is a rail shooter, meaning the player's movements are predetermined and the action focuses on aiming and eliminating enemies. The Extended Cut adds the levels Naked Terror and Creeping Flesh, offering new locations and characters. The game's aesthetic is inspired by 70s exploitation films, featuring excessive gore, sarcastic dialogues, and stylized presentation. It supports solo and co-op gameplay, while the use of PlayStation Move enhances the arcade experience.