Its intro video details the tournament's story, starting around the 1900s as a circus-type caravan that traveled across the country spreading destruction everywhere.

A young Sweet Tooth finds himself amazed by the contest and runs off in its pursuit, entering and eventually winning.

At first revered by the chaos he created, as time went on Sweet Tooth became jealous of Calypso, until he decides to initiate a coup d'état helped by a group of little clowns, and takes control of Twisted Metal.

The musician Rob Zombie is included in the playable characters due to the large number of his songs on the previous installment in the series, Twisted Metal III.

[3] GameSpot's Joe Fielder said that the game was a "huge leap" ahead of Twisted Metal III, commenting on the improved level design, control and physics, but remarked that the latter two "remain a little too touchy and unforgiving", and that the graphics, while "prettier" than those of Twisted Metal III, "aren't nearly as sharp as the graphics in its current main competitor - Activision's Vigilante 8: Second Offense".

[9] IGN's Marc Nix commented negatively on the "toy car" control, look and sound of the vehicles, but noted the "colorful" graphics and "well-done" interactive environments.

[11] GamePro's Dan Amrich said the game would satisfy fans of the Twisted Metal series, highlighting the addition of more weapons, option to create custom cars, visual improvements and hip-hop metal soundtrack, but noted that the increased speed occasionally made it difficult to spot enemies and expressed disappointment towards the recycled sound effects from previous installments.