Almost Total Mayhem is a 2D team-based action platformer that pits two teams against each other in an attempt to destroy the other's base, which comes in the form of medieval forts. In addition teams of knights in armor must also protect their own base from attacks. Also hindering the player's progress is that there is only a single bomb on the map. The graphics come in hand-drawn form on lined A4 paper, and look like someone has doodled them. There is a two player co-operative game mode available for use on a single Xbox 360 console for 2-player split-screen games.