The album's original artwork was that of a man standing in front of a bathroom mirror looking at the reflection of his face falling off, exposing Kreator's mascot demon underneath.

[2] Extreme Aggression was initially recorded in Germany, but those tapes were abandoned, with lead vocalist Mille Petrozza expressing frustration with the band's guitarist Jörg "Tritze" Trzebiatowski.

In its favourable review of the album Billboard wrote, "the playing is very, very tight and drummer Ventor flexes some powerful muscle", while suggesting that "Epic is obviously looking for its own Metallica and this quartet could be it.

"[11] Frank Trojan of Rock Hard considered Extreme Aggression "a clear step backwards from Terrible Certainty", due to "a lack of ideas and moments of surprise", which make the compositions very predictable.

[7] Blabbermouth.net reviewed the 2017 remastered edition of the Extreme Aggression and called it "a genre masterpiece", "superior in terms of songwriting and most certainly production" to its predecessors.