In Total Carnage, an evil Middle Eastern dictator named General Akhboob closes off his country to the rest of the world following a war in 1999. Hundreds of reporters flocked to the zone in hopes of getting a real scoop. Unfortunately for them, one of the reporters discovers that there's more than baby milk being made at the 'Baby Milk Factory'.

General Akhboob then captures the reporter, as well as all the remaining reporters in his country. It turns out that General Akhboob has been building an army of mutants and a stockpile of chemical weapons. He's also holding several American reporters and other civilians captive. It is up to the Doomsday Squad, composed of Captain Carnage (Player 1) and Major Mayhem (Player 2), to invade Akhboob's base, wipe out his forces, destroy the mutants, rescue all the hostages and capture Akhboob.

" When you go into the desert with a rifle, you have respect for the cacti. They stand tall and proud, some of them have been there for over 100 years. They're like the wise old men of the desert, you respect 'em. But jackrabbits, man, the motherfuckers are like flies. You can shoot 'em all day long. "