[5] AllMusic's Johnny Loftus wrote that Only in Amerika is a "thrash-hop spew [which] takes cues from Anthrax, Korn, Dirty South, pre-acting career Ice-T, and the uncompromising Psychopathic Records collective.

Lyrical themes on Only in Amerika primarily consist of sexual intercourse, clubbing, block parties, cannabis and alcohol consumption, angst, and lead rapper Jahred's resentment of pop-punk and censorship (namely that of the FCC and the "corporate faggots" at Jive Records), voicing his indignation toward the state of the music industry at large.

Jahred also makes several pop culture references throughout the album's lyrics, particularly to the O. J. Simpson affair, Trench Coat Mafia, Nick Berg, Nancy Reagan, Shaq, Mary-Kate and Ashley.

On the track "The Box", Jahred references the Bob Marley and the Wailers songs "Get Up, Stand Up", "Burnin' and Lootin'", "No Woman, No Cry", and "Three Little Birds" .

In his review of the album, AllMusic's Johnny Loftus wrote that Only in Amerika "wants to be a confrontational megaphone in the ear of conservatives, but Jahred's torrential rhetoric is too messy and blatantly offensive to incite anything but superficial anger, and the music -- though occasionally explosive -- takes a backseat to the ranting.