On the undercard, Drew McIntyre retained the WWE Intercontinental Championship against Kane, The Miz retained the WWE United States Championship against Montel Vontavious Porter (MVP), and Maryse and Gail Kim competed against LayCool (Layla and Michelle McCool) in an interbrand Divas tag team match.

In late 2009, World Wrestling Entertainment (WWE) held a poll on their official website to allow fans to choose the name for their February 2010 pay-per-view.

[13][14] The February 5 episode of SmackDown saw the five wrestlers qualify to challenge The Undertaker for the World Heavyweight Championship in a similar fashion.

[17] In late December 2009, WWE Divas Champion Melina tore her anterior cruciate ligament, and was forced to vacate the championship.

[22] It was then announced on the February 8 episode of Raw that Maryse and Kim would face one another in the final at the Elimination Chamber pay-per-view.

On the February 12 episode of SmackDown, the WWE Intercontinental Champion Drew McIntyre faced Kane in a non-title match.

[16] It was announced the following day on WWE's official website that Kane and McIntyre would meet at Elimination Chamber for the Intercontinental Championship.

Cena, DiBiase, Orton and Triple H all made their entrances and entered their pods individually, leaving Kingston and Sheamus to start the match.

[24][25] This forced Triple H to tap out, finally ending the match and leading to Cena winning the title, his eighth world championship overall.

Towards the end of the match, McIntyre attempted to leave the arena and lose via countout, which would have allowed him to retain the championship, but Kane brought him back inside the ring.

When re-entering the ring, McIntyre poked him in the eye and then performed his "Future Shock DDT" to win the match by pinfall and remain the Intercontinental Champion.

Maryse and Gail Kim had entered the ring when official consultant to the SmackDown General Manager, Vickie Guerrero interrupted.

He was interrupted by the winner of the 2010 Royal Rumble match, Edge, who stated that he would be deciding which championship to challenge for at WrestleMania on the next episode of Raw.

[24][25] The fifth match was a previously unannounced contest which saw The Miz defend his WWE United States Championship against Montel Vontavious Porter (MVP).

With the referee distracted by this, The Big Show used his "Knockout Punch" on MVP, and The Miz was able to pin him to retain his championship.

[24][25] The main event of the pay-per-view was the SmackDown Elimination Chamber match for the World Heavyweight Championship, featuring The Undertaker, CM Punk, Rey Mysterio, Chris Jericho, John Morrison, and R-Truth.

[24][25] The Undertaker was the fourth to make his way down to the ring, but an accident occurred during his entrance when his pyrotechnics were mistimed, resulting in him being momentarily engulfed in flames.

[28] The final two, who were to start the match, were CM Punk, who was accompanied by his stable, the Straight Edge Society of Serena and Luke Gallows, and R-Truth.

Punk was able to eliminate R-Truth in approximately three-and-a-half minutes, before any other competitor had entered the match, and finished his promo afterward.

This allowed a shocked Jericho to pin The Undertaker to win the match and the World Heavyweight Championship for the third time.

[24][25][29] Just prior to the commencement of the World Heavyweight Championship Elimination Chamber match, The Undertaker was involved in a pyrotechnics accident during his ring entrance.

He suffered first- and second-degree burns to his neck and chest, and according to a WWE spokesperson the injury "looked like a bad sunburn".

[28] Chris Jericho, who also competed in the match, has told on multiple occasions how the pyrotechnician responsible was relieved of his employment with WWE and escorted from the arena following a threat of violence from The Undertaker.

He feels he was saved from severe injury by applying water to his hair, and altering his attire from a sleeveless to a sleeved jacket, just minutes before the accident.

Writing for Canadian Online Explorer's wrestling section, Dale Plummer and Nick Tylwalk also slammed the Divas match, rating it 0.5 out of 10, and stating that it "was pretty much a complete waste of time", a sentiment echoed by the Pro Wrestling Torch's James Caldwell, who stated that the match was a "throwaway".

[24][25] The non-Elimination Chamber matches on the show were mostly derided as being unimportant, with The Baltimore Sun's reviewer Kevin Eck stating that they "came off as filler".

[39][40] On the March 12 episode of SmackDown, Jericho hosted a special edition of his talk show segment, The Highlight Reel, with Edge as the guest.

[42][43] Tension within The Legacy faction had been growing since Cody Rhodes and Ted DiBiase accidentally cost Randy Orton the WWE Championship at the Royal Rumble.

[42] On the final episode of Raw before WrestleMania, Sheamus teamed up with Cody Rhodes and Ted DiBiase to defeat Triple H and Randy Orton in a two-on-three handicap match.

[47] While originally designed for single competitors, the first tag team Elimination Chamber match occurred at the 2015 event.