The art featured on the cover of the album is a painting by Italian Baroque painter Elisabetta Sirani titled Herodias with the Head of John the Baptist, reversed.
William York of AllMusic described None So Vile's sound as "almost entirely relentless," and Ultimate Guitar senior editor David Slavković said "It's really hard to find anything as raw and brutal as Cryptopsy".
"[3][4][5] Decibel characterized the album's sound as demonstrating "monstrous groove, maniacal tempos, savagely bangable riffs and scorched-throat vocals."
Kevin Stewart-Panko of Decibel described Cryptopsy vocalist Lord Worm's vocals as "the most artful use of the death growl ever put on record," and his lyrics as "literate, profane, wryly funny, [and] Burroughs-esque".
William York of AllMusic described Lord Snow's vocals as "a mix of psychotic low-end growls and tortured screams" and called them "suitably intense and scary.