This is a first-person shooter in which players assume the role of Duke Nukem on a mission to save Earth from an alien invasion. Players use pistols, machine guns, rocket launchers, and shrink rays to kill aliens and mutant enemies in frenetic combat. Firefights are accompanied by realistic gunfire, large explosions, and blood-splatter effects. Enemies occasionally break apart into bloody fragments as they are killed. Cutscenes depict additional acts of violence: an alien decapitated by a shotgun blast; an alien's head ripped from its body. The game includes some sexual/suggestive material: depictions of topless women and/or women with tassels on their breasts; dialogue stating “Spank me, spank me” and “Come back to bed, Duke, I'm ready for some action now"; sexual moaning sounds. One mission area depicts a marijuana farm in Amsterdam; smoking from a hookah in this area causes players' character to hallucinate (i.e., screen-warping effects). The words “f**k” and “sh*t” are heard in dialogue.