Twisted Metal features destructive car combat, playable either as a complete tournament or a single match The action takes place in 8 different locations around the world, on differing surfaces, many featuring destructible buildings and landmarks.

Combat takes place between a wide array of vehicles ranging from a man strapped between two wheels to an ice cream truck. They have their own strengths and weaknesses, using an eclectic arrangement of weaponry include bombs and missiles, and resulting in its own end sequence, complete with an ironic line in humour.