MadWorld is a stylish action beat-em up game, that puts player in the role of a police detective gone rogue and taking part in a violent TV show, in which contestants are encouraged to mutilate each other in increasingly violent and gruesome ways.

The game's unique presentation is achieved through a three-colour palette scheme. All the environments, objects and characters are rendered in black and white, as if drawn in a comic book. The only other colour present is red, which accounts for the gallons of blood flowing from the victims of Jack, the game's protagonist. Aside from being inspired by comic books, MadWorld's presentation is also taking hints from the competitive TV shows, with two over-enthusiastic hosts commenting every event happening in the game.

The core of the MadWorld experience is a series of challenges, player must take part in. Each challenge presents a confined arena, in which player should score points by defeating his enemies in the most elaborate way possible and take part in the so-called Bloodbath-Challenges, which present additional rules and timed mini-games (like ManDarts or ManGolf) for racking up the points. Once a sufficient amount of points was met, players must fight a unique boss enemy for the current challenge. When boss is defeated, the player will be free to proceed to the next challenge.

The game also features a heavy use of quick time events in conjuncture with Wii motion-sensitive controls for the finishing moves, mini-games and general tasks, such as avoiding being hit by the enemy.