The game features frequent bloody violence, but as a re-release of an old title, its graphics do not match current standards. The majority of violence takes place against fantasy alien creatures, who fall down with a blood effect or explode apart into gibs when they are shot with any of the weapons (such as shotguns, RPGs, pipe bombs, chain guns and so on). Duke will also frequently encounter half-naked women, who are tied with alien tendrils. The player can choose to leave the women, or shoot them with the same rudimentary gib effect. There are also depictions of the use of illegal drugs when Duke enters a coffee shop, he uses a bong and experiences a trip, and there is one use of the word ‘motherfucker’.