is known for its graphic violent and sexual content, as well as the complexity of the underlying game system, involving higher-level mathematics and an unusual amount of randomization in character development.

It acquired a strongly negative reputation in the tabletop roleplaying community, being universally panned[3] and described as one of the most controversial games ever released.

[4] It is particularly known as the subject of a 2003 review published on RPGnet by Darren MacLennan and Jason Sartin, which described it as "the Necronomicon of role-playing games", in addition to "fundamentally broken in its attitude towards sexuality" and characterized by "bitter misogyny".

[5][note 3] The majority of character traits are determined by random rolls at creation, including ones usually decided by players, such as eye colour, hairstyle, and sexual orientation.

[3] The rules for rape are also incorporated into the section on combat more generally, a design decision that drew criticism for an apparent normalization of sexual violence.

James Hausler, one of the co-creators of the game, later defended the rape content as a design decision by main writer Byron Hall; specifically, the list of mental illnesses characters could roll included multiple paraphilias related to rape and sexual violence, and Hall demanded mechanics be built to accommodate them.

The available spells are also often eclectic, obscene, or peripheral in use, such as "Against Every Wild Animal, Aquatic Creature, and Robbers", "Force Fart", and "Bestow Ulcer".

The spell "Have Her Cadaver"—which makes a deceased woman appear alive but unconscious, and which is described by the rulebook as primarily used for necrophilic sexual intercourse—received a particularly strong negative reception, becoming one of the game's most infamous features.

For instance, the game world lacks significant influence from any actual historical period, while the combat system—heavily focused on damage to specific individual organs—produces unrealistic results like injuring an internal organ without harming the flesh around it.

Other individual mechanics which have drawn attention include the process of determining how many children a pregnant woman gives birth to, which theoretically involves rolling a ten-million-sided die, and the social class system, which refers to serfs (in reality barely above slaves[11]) as a free middle class above the peasantry.

For example, the theme song, described by MacLennan as "sound[ing] like the Cookie Monster chasing a drum kit being pushed down a flight of stairs",[5] has been preserved even after the original web host went down.

Hausler later stated the theme song was by Ryan Keane, one of the game's co-creators, and that it was unrepresentative of his ability as an otherwise talented death metal guitarist.[10]F.A.T.A.L.

The rulebooks for both editions refer to female characters by a number of explicit and insulting sobriquets, such as "cuntress", "slut", and "slovenly whore".

They were also upset by the degree to which negative reviews on the game focused on emotional and shocking content, when Hall believed in "remain[ing] calm and unemotional" in disputes.

However, Hall and Terry did agree with some of the criticisms, such as "brassiere" having been misspelled as "brazier" and that the ethnic stereotype armour should be removed; these were changed in the second edition.