[citation needed] An example of this can be heard in the chorus of "13 Steps to Nowhere", when Phil Anselmo's singing voice is backed up by high-pitched screaming, done by Seth Putnam of the band Anal Cunt.

[7] The lyrical themes on The Great Southern Trendkill include drugs, a flood that ends mankind, finding deeper meaning, anger, and the media.

[8][11][13][14][15][16] The Great Southern Trendkill received mixed to positive reviews from music critics upon release and was more polarizing than Pantera's previous albums.

Steve Huey of AllMusic gave it a score of 3 out of 5 stars and stated, "Longtime Pantera fans will find plenty to enjoy here, and the band's expanding range bodes well, but overall, Trendkill is an inconsistent outing.

"[21] In 2024, Jon Wiederhorn of Loudwire stated "The Great Southern Trendkill writhes and rails with desperation and self-loathing and roars with a new reservoir of aggression and intensity, making it the heaviest album Pantera ever released.