During the course of the game, female characters are sometimes dressed in outfits that reveal large amounts of cleavage or buttocks characters are occasionally depicted nude, though their nipples and/or genitalia are obscured by “pasties” or blurry pixels. Players can also use chainsaws to hack at enemies, resulting in scattered chunks of flesh and large pools of blood. One scene prompts players to run over a certain number of pedestrians within a given time another sequence allows players to dispatch enemies by putting grenades in their mouths.

Players also can shoot at roaming pedestrians (though there is no reward for this action), and in one mission, players shoot at police and civilians to create chaos in a rival gang's territory. Players use machine guns, shotguns, swords, rockets, and grenades to injure and kill rival gang members. As players attempt to take over a fictional city and exact revenge on a rival gang, they engage in driving and combat missions to progress the overall storyline. This is an “open-world” action-adventure game in which players assume the role of criminals known as the Saints.