Painkiller: Battle Out of Hell is considered the first addition to the game that marked the beginning of a whole series of first-person shooters. The sequel introduced 10 new Tarot cards (5 gold and the same number of silver). The arsenal of weapons has increased due to the appearance of two barrels. The Rifle/FlameThrower is a hybrid rifle and flamethrower. He is capable of firing bursts of 8 bullets and showering enemies with fire. The upgrade allows for continuous fire. The second barrel is called Bolt Gun/Heater. This is a bolt launcher with a telescopic sight. He can fire 5 bolts at a time in a straight path. Once modified, they become incendiary. When using the alternate shooting mode, 10 bouncy mines are shot at enemies.

In the official localization, the project has a literally translated name. In Russian translation it is called Painkiller: Battle beyond Hell. The title continues the plot of the first part. This addon can be called the sixth chapter of the story. In “Baptized in Blood”, Daniel was able to defeat Lucifer. However, this did not stop the demonic army. The remnants of the army were led by Alastor. The protagonist decides to go from Purgatory to Hell to deal with this demon. However, the old gate was destroyed, so he will have to find a new path. The game consists of 9 levels (not counting one secret map). Each location has its own setting: a circus, an orphanage, besieged Leningrad, and so on. The developers have slightly upgraded the graphics and reworked the effects. They also added new monsters. Boss battles are also here. Each leader needs to find his own approach.