The event aired via pay-per-view (PPV) and livestreaming and featured wrestlers the promotion's Raw and SmackDown brand divisions.

The main event, which was a Universal Championship Hell in a Cell match between defending champion Seth Rollins and "The Fiend" Bray Wyatt, ended by referee stoppage.

In the other Hell in a Cell match, which was the opening bout, Becky Lynch defeated Sasha Banks to retain the Raw Women's Championship.

In other prominent matches, Daniel Bryan and Roman Reigns defeated Erick Rowan and Luke Harper in a tornado tag team match, and Charlotte Flair defeated Bayley to win the SmackDown Women's Championship for a record fifth time, and her record tenth championship overall on WWE's main roster.

[15] However, the match wasn't necessarily for the Universal Championship, as before Hell in a Cell, Rollins had a scheduled title defense on the September 30 episode of Raw.

As a result, Rollins retained the title, thus officially making his match against The Fiend at Hell in a Cell for the Universal Championship.

[19][20] Rowan then defeated Reigns in a No Disqualification match at Clash of Champions thanks to the returning Luke Harper, reforming their tag team.

Bryan and Reigns then challenged Rowan and Harper to a tag team match at Hell in a Cell, which was made official.

[24] At Clash of Champions, Bayley controversially defeated Charlotte Flair by slamming her head into an exposed turnbuckle to retain the SmackDown Women's Championship.

(United States Champion AJ Styles, Luke Gallows, and Karl Anderson) defeated Cedric Alexander and The Viking Raiders (Ivar and Erik) in a six-man tag team match.

[24] The day of the event, Alexa Bliss and Nikki Cross were scheduled to defend the WWE Women's Tag Team Championship against The Kabuki Warriors (Asuka and Kairi Sane).

[26] Also on the day of the event, after weeks of feuding,[13][27][15][16][17] a match between Natalya and Lacey Evans was scheduled for the Hell in a Cell Kickoff pre-show.

[28] The actual pay-per-view began with Becky Lynch defending the Raw Women's Championship against Sasha Banks in a Hell in a Cell match.

[29] In the fourth match, Alexa Bliss and Nikki Cross defended the WWE Women's Tag Team Championship against The Kabuki Warriors (Asuka and Kairi Sane).

In the climax, while the referee was checking on Bliss and Sane outside the ring, Asuka spat green mist in Cross' face and pinned her after a Roundhouse Kick to win the titles.

(United States Champion AJ Styles, Luke Gallows, and Karl Anderson) faced The Viking Raiders (Ivar and Erik) and a partner of their choosing, which was revealed to be Braun Strowman, in a six-man tag team match.

[29] In the main event, Seth Rollins defended the Universal Championship against "The Fiend" Bray Wyatt in a Hell in a Cell match, which was bathed in red lighting.

After contemplation, Rollins slammed the sledgehammer on top of the weapons over The Fiend, and the referee called for the bell to stop the match without a winner.

After the cage was raised, paramedics tended to The Fiend, who got up and attacked Rollins with the Mandible Claw before throwing him outside the ring, where he performed Sister Abigail.

[31] Mike Tedesco of WrestleView declared Hell in a Cell to be the worst WWE PPV held in 2019 within the United States thus far.

Tedesco wrote that the main event's "bad storytelling" hurt the perception of its participants and the Hell in a Cell match gimmick.

Banks-Lynch was "slow at times with some mistimed spots, but they were innovative in this and worked hard", while Orton-Ali "was pretty damn good" for an unannounced match.

[34] Jason Powell of Pro Wrestling Dot Net stated the "show peaked with the first two matches, but that awful main event finish is one that will be talked about for years to come".

[30] Wade Keller of Pro Wrestling Torch called the main event a "disaster start to finish", stating that it was "stupid" that a Hell in A Cell match was ended because it got too violent.

Keller also described Corbin-Gable as their "least inspired effort so far", the 24/7 title events as "really flat" including "stereotypical zany comedy antics" by the former Japanese wrestler Funaki, and lastly, Orton-Ali as lacking excitement.

Silverstein and Crosby criticized the Universal Championship Hell in a Cell match, saying that the "presentation was solid", but the "booking was horrid".

[44] Erik Beaston of Bleacher Report gave praise to the Raw Women's Championship Hell in a Cell match, giving it a grade of A+, stating that "the need to have a Hell in a Cell match every year watered down the gimmick over time, but after what felt like an eternity, Lynch and Banks returned the intensity, aggression, violence and sense of urgency to the bout".

He called the match "outstanding", and that it "not only reminded fans of how excellent Banks is but also confirmed that Lynch is, without a doubt, the new face of WWE in 2019".

After the match, former tag team champions Alexa Bliss and Nikki Cross ran out and attacked The Kabuki Warriors.

[47][48] On that episode, Bayley, sporting shorter hair and destroying her Bayley-buddies during her entrance, reclaimed the SmackDown Women's Championship from Charlotte Flair.