In survival mode, up to eight players battle for survival in a limited area of one map. The entire single-player campaign can be played by two people and the level of difficulty adjusts in accordance with the two players, either through the number of enemies or hit points. Painkiller: Hell & Damnation also adds several multiplayer modes to the series. New guns are also available such as the Soulcatcher, which shoots saw blades in primary firing mode and sucks the souls out of the enemies with its secondary firing. Several classic weapons return, including the Painkiller, the stakethrower, the shotgun, and the electrodriver. Each level presents a new location with various themes and includes castles, monasteries, graveyards, and more. The game is divided into several chapters, each with several levels. The player has to get through each level, from start to finish, by slaughtering multitudinous demons. Painkiller: Hell & Damnation received a mixed reception among gaming publications.

It was released in North America for Xbox 360 through Xbox Live on October 1, 2013, and for PlayStation 3 through the PlayStation Store on November 26, 2013. The game was released on October 31, 2012, for Microsoft Windows and for PlayStation 3 and Xbox 360 on June 28, 2013, in Europe after suffering multiple delays. Painkiller: Hell & Damnation is a first-person shooter video game, both a remake of and a sequel to Painkiller, developed by The Farm 51 and published by Nordic Games.

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